Organization
SPINAL ELEMENTS NEURODIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY MOORE (MANAGER)
(214) 295-6703
Entity
Organization
Contact information
Practice address
11 DUNEDIN CT, MACON, GA 31210-5393
(214) 295-6703
Mailing address
11 DUNEDIN CT, MACON, GA 31210-5393
(214) 295-6703
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
04/28/2016
Last updated
06/08/2016
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