| NPI | 1942795190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS BLANK Contracting & Credentialing Manager 262-875-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other EEG |
| 261QS1200X Clinic/Center Sleep Disorder Diagnostic | |
| 335V00000X Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2024-09-03 |