| NPI | 1942835897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ROBERT COLLISON Member/Manager 614-439-0053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |