| NPI | 1790893964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAN M WOELTZ Owner 270-443-2830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 87743) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2011-03-24 |