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General NPI Number Information
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NPI Number | 1689691495
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Entity Type | Organization
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Legal Business Name | NEURAL SIGNALS INC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 3400 MCCLURE BRIDGE RD BLDG D SUITE B
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City | DULUTH
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State | GA
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Zip | 30096
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Country | US
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Telephone | 770-220-9964
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Fax | 770-220-9945
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Provider Business Mailing Address
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Address Line | 3400 MCCLURE BRIDGE RD BLDG D SUITE B
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City | DULUTH
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State | GA
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Zip | 30096
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Country | US
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Telephone | 770-220-9964
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Fax | 770-220-9945
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILIP R KENNEDY
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Credential | MD
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Telephone | 770-220-9964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 090106019697
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License Number State | GA
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