| NPI | 1649420019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084H0002X |
| 363A00000X Physician Assistant | |
| 2086S0129X Surgery, Vascular Surgery | |
| 207T00000X Neurological Surgery | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2012-02-01 |