| NPI | 1710102751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WALTER JENSEN Owner Provider 740-452-4053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35082933) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2008-08-28 |