Organization
JGT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAE FUGATE (ELECTRONEURODIAGNOSTIC TECHNICIAN)
(281) 462-1285
Entity
Organization
Contact information
Practice address
1685 S COLORADO BLVD # S-205, DENVER, CO 80222-4000
(281) 462-1285
(281) 462-1554
Mailing address
PO BOX 1288, CROSBY, TX 77532-1288
(281) 462-1285
(281) 462-1554
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
1365
CO
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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