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General NPI Number Information
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NPI Number | 1881197192
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Entity Type | Organization
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Legal Business Name | GEORGE W. RODWAY PROF LLC
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 2145 GREEN VISTA DR STE 112-B
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City | SPARKS
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State | NV
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Zip | 89431-8543
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Country | US
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Telephone | 775-200-9341
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Fax | 775-470-7530
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Provider Business Mailing Address
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Address Line | 3507 WEDEKIND RD
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City | SPARKS
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State | NV
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Zip | 89431-1027
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Country | US
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Telephone | 775-200-9341
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Fax | 775-470-7530
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Authorized Official
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Title or Position | MANAGER
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Name | DR. GEORGE W. RODWAY
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Credential | PHD, APRN
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Telephone | 775-200-9341
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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 | APRN001489
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License Number State | NV
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