Provider Demographics
NPI:1144584814
Name:PHYSICIANS CHOICE NEURO DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:PHYSICIANS CHOICE NEURO DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-595-7795
Mailing Address - Street 1:2813 E CAMELBACK RD STE 430
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4337
Mailing Address - Country:US
Mailing Address - Phone:602-595-7795
Mailing Address - Fax:602-595-7796
Practice Address - Street 1:2813 E CAMELBACK RD STE 430
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4337
Practice Address - Country:US
Practice Address - Phone:602-595-7795
Practice Address - Fax:600-259-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty