Healthcare Provider Details

I. General information

NPI: 1528400199
Provider Name (Legal Business Name): CLOUD 9 SLEEP CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 E MAIN ST SUITE C
FARMINGTON NM
87402
US

IV. Provider business mailing address

6600 E MAIN ST SUITE C
FARMINGTON NM
87402
US

V. Phone/Fax

Practice location:
  • Phone: 505-326-6800
  • Fax:
Mailing address:
  • Phone: 505-326-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL S TORNOW
Title or Position: OWNER
Credential: DMD
Phone: 505-326-6800