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General NPI Number Information
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NPI Number | 1437201506
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Entity Type | Organization
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Legal Business Name | CLNICAL NEURODIAGNOSTICS
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 480 PIERCE ST STE 215
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City | KINGSTON
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State | PA
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Zip | 18704-5512
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Country | US
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Telephone | 570-288-7181
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Fax | 570-288-7633
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Provider Business Mailing Address
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Address Line | 480 PIERCE ST STE 215
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City | KINGSTON
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State | PA
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Zip | 18704-5512
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Country | US
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Telephone | 570-288-7181
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Fax | 570-288-7633
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD L READ
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Credential | PT
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Telephone | 570-288-7181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number |
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License Number State |
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