| NPI | 1730652785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE YOUNG Billing Specialist 270-393-8418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2020-05-20 |