Organization
REVOLUTION NEUROMONITORING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMIAH TITUS VANCE CNIM (PRESIDENT/CEO)
(214) 295-6703
Entity
Organization
Contact information
Practice address
6437 SOUTHPOINT DR, DALLAS, TX 75248-2109
(214) 295-6703
Mailing address
6437 SOUTHPOINT DR, DALLAS, TX 75248
(214) 295-6703
(469) 385-8892
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
05/28/2015
Last updated
06/15/2017
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