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General NPI Number Information
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NPI Number | 1174773667
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Entity Type | Organization
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Legal Business Name | DX2GO
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 301 W STEPHEN FOSTER AVE
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City | BARDSTOWN
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State | KY
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Zip | 40004-1493
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Country | US
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Telephone | 502-724-7883
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Fax |
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Provider Business Mailing Address
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Address Line | 301 WEST STEPHEN FOSTER AVE.
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City | BARDSTOWN
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State | KY
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Zip | 40004-1493
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Country | US
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Telephone | 502-349-6900
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Fax | 502-349-6901
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DONALD P. COYLE JR.
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Credential | B.S., RPSGT
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Telephone | 502-349-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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