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1023578929
BASELINE DIAGNOSTIC
FT WORTH, TX
NPI
1023578929
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Entity Type
Organization
Authorized Contact
GINA SULLIVAN
Billing Manager
817-529-8488
Organization Subpart ?
No
Primary Taxonomy
204R00000X Electrodiagnostic Medicine
Enumeration Date
2019-03-25
Last Update Date
2019-03-25
Business Address
BASELINE DIAGNOSTIC
111 BOLAND ST STE 211
FT WORTH, TX 76107-1265
Phone number: 817-529-8488
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Mailing Address
BASELINE DIAGNOSTIC
PO BOX 25403
LOS ANGELES, CA 90025-0403
Phone number:
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