Healthcare Provider Details

I. General information

NPI: 1508198029
Provider Name (Legal Business Name): NO WAKE ZONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4133 PERIDOT DR
VIRGINIA BEACH VA
23456-5807
US

IV. Provider business mailing address

4133 PERIDOT DR
VIRGINIA BEACH VA
23456-5807
US

V. Phone/Fax

Practice location:
  • Phone: 757-286-8030
  • Fax:
Mailing address:
  • Phone:
  • 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: CORY ARNOLD
Title or Position: TECHNICAL DIRECTOR
Credential:
Phone: 757-286-8030