Organization
INNOVASIS NEUROLOGICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY DOUCET (BILLING DEPARTMENT)
(281) 462-1285
Entity
Organization
Contact information
Practice address
614 E 3900 S, SALT LAKE CITY, UT 84107-1902
(281) 462-1285
(281) 462-1554
Mailing address
614 E 3900 S, SALT LAKE CITY, UT 84107-1902
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
07/20/2011
Last updated
07/20/2011
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