Organization
NEURODIAGNOSTICS LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE BREEDEN (OFFICE MANAGER)
(505) 326-7153
Entity
Organization
Contact information
Practice address
4801 N BUTLER AVE, STE. 8102, FARMINGTON, NM 87401-0818
(505) 326-7153
(505) 326-7767
Mailing address
4801 N BUTLER AVE, STE. 8102, FARMINGTON, NM 87401-0818
(505) 326-7153
(505) 326-7767
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2000-14
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69631
—
NM
Enumeration date
12/26/2006
Last updated
12/21/2007
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