Healthcare Provider Details

I. General information

NPI: 1932416492
Provider Name (Legal Business Name): NEUROTRACK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2010
Last Update Date: 09/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7264 LARIX RD
LAS VEGAS NV
89113-3223
US

IV. Provider business mailing address

7264 LARIX RD
LAS VEGAS NV
89113-3223
US

V. Phone/Fax

Practice location:
  • Phone: 702-979-1894
  • Fax:
Mailing address:
  • Phone: 702-979-1894
  • 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: NARWHAL HOLDINGS
Title or Position: PRESIDENT
Credential:
Phone: 702-979-1894