Organization
SYNERGIST LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW WAVRA (PARTNER)
(307) 201-2610
Entity
Organization
Contact information
Practice address
1910 THOMES AVE, CHEYENNE, WY 82001-3527
(307) 201-2610
Mailing address
4580 KLAHANIE DR SE, ISSAQUAH, WA 98029-5812
(425) 890-6239
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
2472E0500X
EEG Technician
—
—
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
09/18/2017
Last updated
03/22/2018
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