| NPI | 1710720990 |
|---|---|
| Doing Business As | MINDSPACE MEDICAL |
| Entity Type | Organization |
| Authorized Contact | BRENT SMITH Medical Director 570-260-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-06-17 |