Organization
ICN PLLC
Active
Other names
Institute for Clinical Neurosciences
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY LEE GANT PHD (PRESIDENT)
(720) 552-2995
Entity
Organization
Contact information
Practice address
255 CANYON BLVD STE 300-F, BOULDER, CO 80302-4979
(972) 570-8200
(972) 402-5621
Mailing address
5455 LEE HILL DR, BOULDER, CO 80302-9305
(720) 552-2995
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2998
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000167953
—
CO
Enumeration date
02/03/2017
Last updated
01/02/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us