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General NPI Number Information
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NPI Number | 1427348630
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Entity Type | Organization
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Legal Business Name | SOUTHWEST NEUROMONITORING LLC
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Dates
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Enumeration Date | 04/10/2011
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Last Update Date | 04/10/2011
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Provider Practice Location Address
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Address Line | 1666 S STUART ST
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City | DENVER
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State | CO
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Zip | 80219-4457
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Country | US
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Telephone | 303-842-1512
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Fax | 303-936-4424
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Provider Business Mailing Address
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Address Line | PO BOX 19697
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City | DENVER
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State | CO
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Zip | 80219-0697
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Country | US
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Telephone | 303-842-1512
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Fax | 303-936-4424
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DIANNE GALLEGOS
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Credential | MS, CNIM
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Telephone | 303-842-1512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 414
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License Number State | CO
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