| NPI | 1578759379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT WENGER Owner 352-333-1109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME86559) |
| Enumeration Date | 2007-09-15 |
| Last Update Date | 2007-09-15 |