| NPI | 1699728972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE M ATCHISON Biller/Credentialling Specialist 937-439-6186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-07-18 |