| NPI | 1487143806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERREL BOYER Owner 606-225-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2022-01-31 |