Provider Demographics
NPI:1467576801
Name:NEUROSCIENCE SERVICES, P.C.
Entity Type:Organization
Organization Name:NEUROSCIENCE SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:O
Authorized Official - Last Name:WEATHERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-734-2977
Mailing Address - Street 1:101 1ST AVE NE STE 150
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-2995
Mailing Address - Country:US
Mailing Address - Phone:256-734-2977
Mailing Address - Fax:256-734-4345
Practice Address - Street 1:800 SAINT VINCENTS DR STE 710
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1633
Practice Address - Country:US
Practice Address - Phone:256-558-3653
Practice Address - Fax:256-558-3654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty