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General NPI Number Information
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NPI Number | 1386658490
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Entity Type | Organization
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Legal Business Name | PHYSICIAN SLEEP DIAGNOSTIC CENTERS, LLC
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7756 WASHINGTON VILLAGE DR SUITE A
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City | DAYTON
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State | OH
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Zip | 45459-3953
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Country | US
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Telephone | 937-425-0035
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Fax | 937-425-8959
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Provider Business Mailing Address
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Address Line | 7756 WASHINGTON VILLAGE DR SUITE A
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City | CENTERVILLE FINANCE
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State | OH
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Zip | 45459-3953
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Country | US
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Telephone | 937-425-0035
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Fax | 937-425-8959
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BRUCE M. FERRIS
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Credential |
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Telephone | 937-425-0035
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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 | OH
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