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Organization

PERIPHERY NEUROPHYSIOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD TIMM CNIM, R. EEG T. (CEO)
(801) 674-9066
Entity
Organization

Contact information

Practice address
49 PLEASANT ST, EPPING, NH 03042-3512
(801) 674-9066
Mailing address
49 PLEASANT ST, EPPING, NH 03042-3512
(801) 674-9066

Taxonomy

Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
2084N0600X
Clinical Neurophysiology Physician
246ZE0600X
Electroneurodiagnostic Specialist/Technologist

Other

Enumeration date
09/20/2019
Last updated
11/27/2023
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