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Organization
MAG LLC
Active
Organization
MAG LLC
Active
Other names
NEURO DIAGNOSTIC ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE GRIZZAFFI (CEO/PARTNER)
(225) 413-7375
Entity
Organization
Contact information
Practice address
11737 WENTLING AVENUE, SUITE A, BATON ROUGE, LA 70816-6053
(225) 413-7375
(225) 208-1400
Mailing address
8738 GRAND VIEW DRIVE, BATON ROUGE, LA 70809-5230
(225) 413-7375
(225) 208-1400
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
01/16/2008
Last updated
04/08/2010
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