Organization
SOURCE MONITORING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY L GREEN (MEMBER)
(713) 818-5703
Entity
Organization
Contact information
Practice address
15 MIRROR RIDGE DR, THE WOODLANDS, TX 77382-2507
(713) 628-8587
Mailing address
15 MIRROR RIDGE DR, THE WOODLANDS, TX 77382-2507
(713) 628-8587
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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