Organization
NKL NEUROLOGY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIDA K LAURIN M.D. (OWNER/PHYSICIAN)
(480) 779-3997
Entity
Organization
Contact information
Practice address
9817 N 95TH ST STE 110, SCOTTSDALE, AZ 85258-4587
(480) 779-3997
(480) 779-1305
Mailing address
9817 N 95TH ST STE 110, SCOTTSDALE, AZ 85258-4587
(480) 779-3997
(480) 779-1305
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35284
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
955263
—
AZ
Enumeration date
05/14/2010
Last updated
03/06/2012
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