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General NPI Number Information
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NPI Number | 1306020268
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Entity Type | Organization
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Legal Business Name | ADVANCED SLEEP LABS, L.L.C.
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 525 N. KEENE STREET SUITE 302
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City | COLUMBIA
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State | MO
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Zip | 65201
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Country | US
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Telephone | 573-449-2141
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Fax | 573-875-2328
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Provider Business Mailing Address
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Address Line | 525 N. KEENE STREET SUITE 302
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City | COLUMBIA
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State | MO
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Zip | 65201
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Country | US
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Telephone | 636-207-0537
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Fax | 636-207-0221
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Authorized Official
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Title or Position | DIRECTOR
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Name | DAVID L MCLAREN
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Credential | M.D.
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Telephone | 573-449-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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