Organization
NEUROPHYSIOLOGY LABORATORIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ATEER SHETH (SOLE MBR)
(404) 642-0259
Entity
Organization
Contact information
Practice address
260 PEACHTREE ST STE 2200, ATLANTA, GA 30303-1292
(404) 419-1319
Mailing address
PO BOX 2259, GRIFFIN, GA 30224-0057
(404) 419-1319
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
639
GA
261QM2500X
Medical Specialty Clinic/Center
639
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
639
CNIM
GA
Enumeration date
04/05/2011
Last updated
04/05/2011
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