| NPI | 1861934036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MOONEY Owner 888-954-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2021-02-02 |