| NPI | 1598036972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES TAYLOR Statutory Agent 937-304-5955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35089261) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |