| NPI | 1669226361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN OWEN BAILEY CEO 251-471-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |