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Organization

AXIS INCORPORATED LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MAROMI DHUPAR-SAKURAI (OWNER/PRESIDENT)
(970) 818-6190
Entity
Organization

Contact information

Practice address
1816 SEA SHELL CT, WINDSOR, CO 80550
(970) 818-6190
(970) 460-0581
Mailing address
1816 SEA SHELL CT, WINDSOR, CO 80550
(970) 818-6190
(970) 460-0581

Taxonomy

Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
293D00000X
Physiological Laboratory
363A00000X
Physician Assistant
1512
CO

Other

Enumeration date
06/27/2008
Last updated
02/19/2015
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