Organization
PRO IOM, LLC
Active
Organization
PRO IOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNA LAROQUE (MANAGER, CLIENT EXPERIENCE)
(210) 598-2801
Entity
Organization
Contact information
Practice address
6301 N WESTERN AVE STE 250, OKLAHOMA CITY, OK 73118-1045
(405) 207-9450
Mailing address
1141 N LOOP 1604 E # 105-612, SAN ANTONIO, TX 78232-1339
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
12/02/2021
Last updated
04/18/2022
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