# NEURORADIANCE INTEGRATIVE HEALTH INITIATIVE, LTD

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

## Provider details

- **NPI number:** 1750926317
- **Authorized official:** RICHARD COOPER MD (OWNER)
- **Authorized official phone:** (614) 776-0624

## Contact information

- **Practice address:** 110 POLARIS PKWY STE 120, WESTERVILLE, OH 43082-8028
- **Practice address phone:** (614) 776-0624
- **Practice address fax:** (614) 591-9486
- **Mailing address:** 110 POLARIS PKWY STE 120, WESTERVILLE, OH 43082-8028
- **Mailing address phone:** (614) 776-0624

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/07/2019
- **Last updated:** 11/07/2019