| NPI | 1710179155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN ANDERSON Office Manager 270-926-6867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 21205) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2007-08-09 |