| NPI | 1669161444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS STANTON COSPER Owner/Pa C 330-507-2988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-22 |