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Organization
MBC-IOM, LLC.
Active
Organization
MBC-IOM, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONYA M GILLIAM (OWNER)
(972) 632-6877
Entity
Organization
Contact information
Practice address
627 RIDGEMONT DR, ALLEN, TX 75002-6100
(972) 632-6877
(972) 364-1249
Mailing address
627 RIDGEMONT DR, ALLEN, TX 75002-6100
(972) 632-6877
(972) 364-1249
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
Primary
—
—
Other
Enumeration date
05/15/2015
Last updated
05/15/2015
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