| NPI | 1700165891 |
|---|---|
| Doing Business As | WK TRISTATE NEUROLOGY CLINIC |
| Entity Type | Organization |
| Authorized Contact | GREG J. GAVIN Network Administrator 318-212-4232 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2011-11-23 |