Organization
DEFINITIVE NEURODIAGNOSTICS, LLC PROFESSIONAL SERVICES
Active
Parent organization
DEFINITIVE NEURODIAGNOSTICS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEFINITIVE NEURODIAGNOSTICS, LLC
Authorized official
DR. JOHN G ATWATER M.D. (OWNER)
(309) 454-1100
Entity
Organization
Contact information
Practice address
1604 VISA DR # 1, NORMAL, IL 61761-2195
(309) 454-1100
Mailing address
1604 VISA DR # 1, NORMAL, IL 61761-2195
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
036100906
IL
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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