| NPI | 1891144523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA TERRELL Billing Specialist 267-639-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA MD048939L) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |