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General NPI Number Information
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NPI Number | 1629154828
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Entity Type | Organization
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Legal Business Name | NORTHWEST NEUROLOGY PC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 90 HEALTH PARK DR
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City | LOUISVILLE
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State | CO
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Zip | 80027-9757
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Country | US
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Telephone | 303-426-0215
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Fax | 303-426-4003
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Provider Business Mailing Address
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Address Line | 90 HEALTH PARK DR. 390
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City | LOUISVILLE
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State | CO
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Zip | 80027-9742
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Country | US
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Telephone | 303-426-0215
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Fax | 303-426-4003
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Authorized Official
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Title or Position | BILLING MGR
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Name | MS. SANDI HYNES
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Credential |
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Telephone | 303-426-0215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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