Provider Demographics
NPI:1174280069
Name:NERVE WATCH LLC
Entity Type:Organization
Organization Name:NERVE WATCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-868-1971
Mailing Address - Street 1:PO BOX 29650
Mailing Address - Street 2:DEPT 880235
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038
Mailing Address - Country:US
Mailing Address - Phone:844-868-1971
Mailing Address - Fax:
Practice Address - Street 1:221 N BROAD ST STE 3A
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1070
Practice Address - Country:US
Practice Address - Phone:888-888-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-26
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty