NPI | 1487886289 |
---|---|
Doing Business As | AWAKENED MIND VITALITY CLINIC |
Entity Type | Organization |
Authorized Contact | CHRIS LUCEY Office Manager 608-781-6463 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 40442020) |
Enumeration Date | 2009-08-13 |
Last Update Date | 2009-08-25 |