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General NPI Number Information
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NPI Number | 1699279455
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Entity Type | Organization
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Legal Business Name | NEUROLOGICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 100 TRACY WAY
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City | CHARLESTON
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State | WV
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Zip | 25311-1257
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Country | US
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Telephone | 304-343-4583
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Fax | 304-343-9207
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Provider Business Mailing Address
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Address Line | 100 TRACY WAY
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City | CHARLESTON
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State | WV
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Zip | 25311-1257
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Country | US
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Telephone | 304-343-4583
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Fax | 304-343-9207
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DIANA K WILLIAMSON
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Credential | CPA
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Telephone | 304-344-3551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | WV
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