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General NPI Number Information
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NPI Number | 1174530141
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Entity Type | Organization
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Legal Business Name | MIDWEST NEUROSCIENCE INC
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 1 E MAIN ST STE 200A
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City | NORWALK
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State | OH
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Zip | 44857-1557
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Country | US
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Telephone | 419-663-0020
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Fax | 419-663-1859
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Provider Business Mailing Address
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Address Line | 1 E MAIN ST STE 200A
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City | NORWALK
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State | OH
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Zip | 44857-1557
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | THOMAS SWANSON MD
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Credential |
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Telephone | 419-663-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State | OH
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