MEDICARE: NEUROTRACK

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	:	1932416492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROTRACK

Provider Business Mailing Address
First Line	:	7264 LARIX RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3223
Country	:	US
Telephone Number	:	702-979-1894
Fax Number	:

Provider Business Practice Location Address
First Line	:	7264 LARIX RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3223
Country	:	US
Telephone Number	:	702-979-1894
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NARWHAL HOLDINGS
Credential	:
Telephone Number	:	702-979-1894

Provider Enumeration Date	:	09/06/2010
Last Update Date	:	09/30/2010

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Directions to “NEUROTRACK ” Practice Location

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