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1093450975
LIBERTY IOM LLC
FT WORTH, TX
NPI
1093450975
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Entity Type
Organization
Authorized Contact
GINA SULLIVAN
Practice Administrator
903-259-0550
Organization Subpart ?
No
Primary Taxonomy
204R00000X Electrodiagnostic Medicine
Enumeration Date
2022-05-04
Last Update Date
2022-05-04
Business Address
LIBERTY IOM LLC
111 BOLAND ST STE 211
FT WORTH, TX 76107-1265
Phone number: 817-529-8488
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Mailing Address
LIBERTY IOM LLC
111 BOLAND ST STE 211
FT WORTH, TX 76107-1265
Phone number: 817-529-8488
Copy
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