| NPI | 1669619417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSEL PACKARD Owner 888-395-4007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX L5082) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-01-15 |