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General NPI Number Information
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NPI Number | 1740581834
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Entity Type | Organization
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Legal Business Name | NORTHWEST ARKANSAS SLEEP DIAGNOSTICS LLC
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Dates
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Enumeration Date | 11/05/2010
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 350 E MILLSAP RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4098
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Country | US
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Telephone | 479-587-8753
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Fax |
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Provider Business Mailing Address
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Address Line | 302 E HERSEY ST STE 12
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City | ASHLAND
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State | OR
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Zip | 97520-1957
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Country | US
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Telephone | 541-646-0858
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Fax | 541-488-7721
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Authorized Official
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Title or Position | MANAGER
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Name | DODIE RACHEL NOLES
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Credential |
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Telephone | 541-646-0858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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