MEDICARE: PROFESSIONAL READING, 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	:	1972717718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL READING, LLC

Provider Business Mailing Address
First Line	:	PO BOX 237
Second Line	:
City	:	OSAKIS
State	:	MN
Zip	:	56360-0237
Country	:	US
Telephone Number	:	720-308-4567
Fax Number	:	720-489-3888

Provider Business Practice Location Address
First Line	:	5756 GENOA WAY
Second Line	:	#205
City	:	AURORA
State	:	CO
Zip	:	80019-2090
Country	:	US
Telephone Number	:	702-308-4567
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ADRIAN PANTHER
Credential	:
Telephone Number	:	720-308-4567

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	03/24/2015

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