| NPI | 1548718703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LY Owner 256-335-5754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD0000054532) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2017-04-21 |