Organization
5280 IOM, LLC
Active
Organization
5280 IOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLA DONNER (CO-OWNER)
(281) 462-7684
Entity
Organization
Contact information
Practice address
1700 BASSETT ST UNIT 1021, DENVER, CO 80202-1921
(281) 462-7684
(888) 832-5078
Mailing address
PO BOX 1651, CROSBY, TX 77532-1651
(281) 462-7684
(888) 832-5078
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
CNIM1816
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNIM 1816
CERTIFIED NEURO-INTRAOPERATIVE MONITOIRNG
CO
01
—
CNIM 2012
CERTIFIED NEURO-INTRAOPERATIVE MONITOIRNG
CO
Enumeration date
10/03/2016
Last updated
10/03/2016
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