Healthcare Provider Details

I. General information

NPI: 1427248277
Provider Name (Legal Business Name): SPECTRUM SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3403 IMPERATOR LN SUITE 101
LOUISVILLE KY
40245-7711
US

IV. Provider business mailing address

2403 GOLF RD
PHILADELPHIA PA
19131-1416
US

V. Phone/Fax

Practice location:
  • Phone: 215-432-9914
  • Fax:
Mailing address:
  • Phone: 215-432-9914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN RAY
Title or Position: GENERAL MANAGER
Credential: CNIM
Phone: 215-432-9914