Organization
ONE SOURCE DIAGNOSTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADY LEE WHITE RRT-RCP (PRESIDENT)
(828) 781-7413
Entity
Organization
Contact information
Practice address
3314 16TH AVE SE, SUITE 201, CONOVER, NC 28613-9694
(704) 325-0810
(704) 325-0812
Mailing address
3314 16TH AVE SE, SUITE 201, CONOVER, NC 28613-9694
(704) 325-0810
(704) 325-0812
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
A-559
NC
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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