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General NPI Number Information
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NPI Number | 1275729659
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Entity Type | Organization
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Legal Business Name | NEUROLOGY SOLUTIONS
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 11/22/2007
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Provider Practice Location Address
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Address Line | 1015 S MERCER AVE
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City | BLOOMINGTON
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State | IL
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Zip | 61701-7107
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Country | US
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Telephone | 309-661-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 4 HONEYSUCKLE CT
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City | BLOOMINGTON
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State | IL
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Zip | 61704-1533
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Country | US
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Telephone | 309-661-4325
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICK KERWIN LASHER
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Credential | M.D.
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Telephone | 309-661-4325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | IL
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