| NPI | 1821788530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THRESA CLEMONS Credentialing Specialist 501-320-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-07-31 |