| NPI | 1720233570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE JOHN JEDLICKA President 907-290-6355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 33547) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2018-11-19 |