Organization Name: | MOUNTAIN VIEW NEUROCARE, LLC |
NPI Number: | 1467809657 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MINDY WAKEMAN (OWNER) |
Mailing Address: | 592 Traildust Dr Milliken |
State: | CO US |
Postal Code: | 805433030 |
Phone Number: | 9704050319 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2016 |
NPI Last Update Date: | 05/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246ZE0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | Electroneurodiagnostic |
Taxonomy Definition: |