Organization
ADVANCED NEURO MONITORING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRASE MAHAN (MANAGER)
(214) 675-0905
Entity
Organization
Contact information
Practice address
9521 RIVERSIDE PKWY STE B, SUTE 338, TULSA, OK 74137-7422
(214) 675-0905
(214) 317-4888
Mailing address
PO BOX 108809, OKLAHOMA CITY, OK 73101-8809
(214) 675-0905
(214) 317-4888
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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