| NPI | 1891073573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J WAGNER Owner 330-929-2580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 44925) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-07-28 |