Organization
INNOVATIVE SLEEP DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMIE ROYCE DAUGHERTY II (PRESIDENT)
(423) 764-4480
Entity
Organization
Contact information
Practice address
1104 TUSCULUM BLVD, STE 301, GREENEVILLE, TN 37745-4091
(423) 764-1579
Mailing address
105 MEADOWVIEW RD, STE 2, BRISTOL, TN 37620-1725
(423) 764-4480
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2007
Last updated
10/18/2007
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