| NPI | 1598718074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J. BLACKBURN President 800-824-2543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-10-16 |