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General NPI Number Information
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NPI Number | 1508233032
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Entity Type | Organization
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Legal Business Name | USA SLEEP DIAGNOSTIC MOBILE SERVICES, LLC
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 03/17/2020
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Provider Practice Location Address
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Address Line | 392 GARRISONVILLE RD STE 210B
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City | STAFFORD
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State | VA
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Zip | 22554-1500
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Country | US
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Telephone | 888-792-4445
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Fax | 888-226-4773
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Provider Business Mailing Address
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Address Line | 6030 DAYBREAK CIR STE A150260
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1642
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Country | US
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Telephone | 888-792-4445
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Fax | 888-226-4773
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Authorized Official
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Title or Position | OWNER
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Name | THURLYN WILSON
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Credential |
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Telephone | 888-792-4445
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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 | 20179
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License Number State | PA
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