# NEURO DYNAMICS PENN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649745803
- **Authorized official:** MR. JAY L KROTTINGER (COO)
- **Authorized official phone:** (918) 932-2734

## Contact information

- **Practice address:** 100 N 18TH ST, STE 300, PHILADELPHIA, PA 19103
- **Practice address phone:** (918) 770-9333
- **Practice address fax:** (918) 213-4888
- **Mailing address:** PO BOX 1430, LOCKBOX \#5120, JENKS, OK 74034-1430
- **Mailing address phone:** (918) 932-2734
- **Mailing address fax:** (918) 932-2734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 10/03/2018
- **Last updated:** 01/09/2019