| NPI | 1689979031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LANE BOURQUE President 972-971-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2011-05-17 |