| NPI | 1568070647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK GRAY III Director 844-212-5321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 2472E0500X Technician, Other, EEG |
| 261QR0200X Clinic/Center, Radiology | |
| 246ZE0500X Specialist/Technologist, Other, EEG | |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2021-01-28 |