Organization
INTACT NEUROMONITORING, LLC
Active
Organization
INTACT NEUROMONITORING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANNE MICSKY CNIM (CO OWNER)
(724) 689-9591
Entity
Organization
Contact information
Practice address
3295 BLAKE ST APT 304, DENVER, CO 80205-2469
(724) 689-9591
Mailing address
PO BOX 40856, DENVER, CO 80204-0856
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1816
CERTIFIED NEURO - INTRAOPERATIVE MONITORING
—
01
—
2012
CERTIFIED NEURO - INTRAOPERATIVE MONITORING
—
Enumeration date
01/24/2020
Last updated
01/24/2020
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