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General NPI Number Information
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NPI Number | 1003837048
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Entity Type | Organization
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Legal Business Name | NEUROLOGICAL ASSOCIATES OF SOUTHEAST OHIO INC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 945 BETHESDA DR SUITE 230
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City | ZANESVILLE
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State | OH
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Zip | 43701-0801
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Country | US
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Telephone | 740-453-0680
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Fax | 740-453-5158
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Provider Business Mailing Address
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Address Line | 945 BETHESDA DR SUITE 230
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City | ZANESVILLE
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State | OH
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Zip | 43701-0801
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Country | US
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Telephone | 740-453-0680
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Fax | 740-453-5158
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. REBECCA J GLASS
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Credential |
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Telephone | 740-453-0680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35039044
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License Number State | OH
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