| NPI | 1871980631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MITCHELL Practice Manager 386-673-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-04-20 |