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ADVANCED NEUROLOGIC ASSOCIATES, INC

Physicians Psychiatry & Neurology Neurology

Provider NPI: 1740594738

Organization Information:
Organization Name:  ADVANCED NEUROLOGIC ASSOCIATES, INC
Organization is not Subpart
Authorized Official:  STEVEN  BENEDICT  PRESIDENT  419-483-2403

Practice Location:
110 E HOWARD ST  WILLARD, OH 44890-1611 US
Tel: 419-483-2403  Fax: 419-484-1203

Business Mailing Address:
5433 STATE ROUTE 113  BELLEVUE, OH 44811-9708 US
Tel: 419-483-1203  Fax: 419-484-1203

NPI Information:
NPI: 1740594738
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2084N0400XPhysicians
Psychiatry & Neurology
Neurology

Other Provider Identifiers:

IssuerNumberStateType
2383620OH05
RAILROAD MEDICARECL1664OH01



American Medical Association 2012 taxonomy code information

Code: 2084N0400X

Type:

Classification:



Definition:



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