Organization
ENCEPHALON NEURODIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY MCMILLAN II (CHIEF OPERATING OFFICER)
(571) 206-7311
Entity
Organization
Contact information
Practice address
46715 WESTOVER TER, STERLING, VA 20165-7506
(571) 206-7311
Mailing address
46715 WESTOVER TER, STERLING, VA 20165-7506
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
S5386612
VA
Other
Enumeration date
01/12/2015
Last updated
01/15/2015
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