Healthcare Provider Details

I. General information

NPI: 1285884387
Provider Name (Legal Business Name): DEEP SLEEP LABORATORIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 TATE BLVD SE STE 614
HICKORY NC
28602-1433
US

IV. Provider business mailing address

1730 N CENTER ST
HICKORY NC
28601-1851
US

V. Phone/Fax

Practice location:
  • Phone: 828-855-0701
  • Fax: 828-322-5252
Mailing address:
  • Phone: 828-322-3222
  • Fax: 828-322-5252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOEL KUNZE
Title or Position: CEO
Credential:
Phone: 828-322-3222