| Organization Name: | DIAGNOSTIC SLEEP AND RESPIRATORY CENTER LLC |
| NPI Number: | 1255528741 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENA MARIE HACKWORTH-STOCKETT (OWNER/ CLINICAL DIRECTOR) |
| Mailing Address: | 282 E 4th St Benson |
| State: | AZ US |
| Postal Code: | 856026612 |
| Phone Number: | 5205864729 |
| Fax Number: | 5204233977 |
| NPI Enumeration Date: | 09/27/2007 |
| NPI Last Update Date: | 03/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1200X |
| License Number: | 9504 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Sleep Disorder Diagnostic |
| Taxonomy Definition: | |