MEDICARE: IMPULSE DIAGNOSTICS 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	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1467570119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMPULSE DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	3601 N MAY AVE STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6659
Country	:	US
Telephone Number	:	405-604-5613
Fax Number	:	405-601-3750

Provider Business Practice Location Address
First Line	:	3601 N MAY AVE STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6659
Country	:	US
Telephone Number	:	405-604-5613
Fax Number	:	405-601-3750

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DEBRA JOY PARRISH
Credential	:
Telephone Number	:	405-604-5613

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/17/2008

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Directions to “IMPULSE DIAGNOSTICS LLC ” Practice Location

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