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General NPI Number Information
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NPI Number | 1447618509
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Entity Type | Organization
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Legal Business Name | NEUROMEDICAL LLC
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 4578 N 1ST AVE STE 100
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City | TUCSON
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State | AZ
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Zip | 85718-5748
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Country | US
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Telephone | 520-338-2557
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Fax |
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Provider Business Mailing Address
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Address Line | 4578 N 1ST AVE STE 100
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City | TUCSON
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State | AZ
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Zip | 85718-5748
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Country | US
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Telephone | 520-338-2557
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Fax | 520-844-9535
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | WENDY LYNN BURTNESS
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Credential |
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Telephone | 520-338-2557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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