| NPI | 1659113173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JEFFREY ZIZMOR Physician 341-222-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2025-07-24 |