MEDICARE: IOM HAND LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1366891780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IOM HAND LLC

Provider Business Mailing Address
First Line	:	5729 LEBANON RD
Second Line	:	STE 144
City	:	FRISCO
State	:	TX
Zip	:	75034-7260
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5729 LEBANON RD
Second Line	:	STE 144
City	:	FRISCO
State	:	TX
Zip	:	75034-7260
Country	:	US
Telephone Number	:	469-919-3549
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARIA CARMEN
Credential	:
Telephone Number	:	469-919-3549

Provider Enumeration Date	:	06/07/2016
Last Update Date	:	06/07/2016

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Directions to “IOM HAND LLC ” Practice Location

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