| NPI | 1649877598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA DIANNE WELDER Office Mananger 228-865-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-05 |