| NPI | 1124471370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAIRLENA KAYE BAKUN Owner 606-439-3399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |