Organization
NEUROLOGY SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO M OLIVEIRA MD (OWNER)
(719) 632-5155
Entity
Organization
Contact information
Practice address
1519 E BOULDER ST, COLORADO SPRINGS, CO 80909-5663
(719) 632-5155
Mailing address
1519 E BOULDER ST, COLORADO SPRINGS, CO 80909-5663
(719) 632-5155
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
23688
CO
Other
Enumeration date
06/09/2008
Last updated
08/11/2008
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