Provider Demographics
NPI:1407206121
Name:CHOICE NEURODIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:CHOICE NEURODIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:POREE
Authorized Official - Suffix:JR
Authorized Official - Credentials:CNIM
Authorized Official - Phone:404-805-4288
Mailing Address - Street 1:5825 GLENRIDGE DR
Mailing Address - Street 2:BLDG 3 STE 101
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5387
Mailing Address - Country:US
Mailing Address - Phone:404-303-5102
Mailing Address - Fax:
Practice Address - Street 1:176 MINE LAKE CT
Practice Address - Street 2:STE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6417
Practice Address - Country:US
Practice Address - Phone:404-428-7041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty