MEDICARE: MUSCLE & ROM TESTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1356485890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUSCLE & ROM TESTING LLC

Provider Business Mailing Address
First Line	:	3726 MILITARY PIKE
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40513
Country	:	US
Telephone Number	:	800-476-2213
Fax Number	:

Provider Business Practice Location Address
First Line	:	3726 MILITARY PIKE
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40513
Country	:	US
Telephone Number	:	800-476-2213
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. DAVID W BARUCH
Credential	:	B.S. MEDICAL SCIENCE
Telephone Number	:	954-448-4610

Provider Enumeration Date	:	02/17/2007
Last Update Date	:	08/22/2020

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