| NPI | 1548747066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES FORAGE Sole Member 800-310-7334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204R00000X Electrodiagnostic Medicine (Licence: NV 10801) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2019-04-10 |