| NPI | 1619340817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD BELCHER CEO 740-360-4684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| 2251S0007X Physical Therapist, Sports | |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2018-06-22 |