Organization
DIVA INTRA-OPERATIVE MONITORING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN J IPSEN M.D. (MEMBER)
(620) 783-4441
Entity
Organization
Contact information
Practice address
444 FOUR STATES DR, GALENA, KS 66739-4324
(620) 783-4441
Mailing address
444 FOUR STATES DR, GALENA, KS 66739-4324
(620) 783-4441
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
11/19/2015
Last updated
07/06/2016
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