Organization
NEUROLIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA DAVIS (ACCOUNT MANAGER)
(770) 443-4483
Entity
Organization
Contact information
Practice address
1266 W PACES FERRY RD NW STE 646, ATLANTA, GA 30327-2306
(770) 443-4483
(110) 443-4410
Mailing address
PO BOX 646, ATLANTA, GA 30301-0646
(770) 443-4483
(770) 443-4410
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
32943
—
246Z00000X
Other Specialist/Technologist
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
32943
—
Other
Enumeration date
03/11/2009
Last updated
03/11/2009
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