Provider Demographics
NPI:1689691495
Name:NEURAL SIGNALS INC
Entity Type:Organization
Organization Name:NEURAL SIGNALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:R
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-220-9964
Mailing Address - Street 1:3400 MCCLURE BRIDGE RD
Mailing Address - Street 2:BLDG D SUITE B
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096
Mailing Address - Country:US
Mailing Address - Phone:770-220-9964
Mailing Address - Fax:770-220-9945
Practice Address - Street 1:3400 MCCLURE BRIDGE RD
Practice Address - Street 2:BLDG D SUITE B
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:770-220-9964
Practice Address - Fax:770-220-9945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA090106019697332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5100610001OtherSUPPLIER ID
GA5100610001OtherSUPPLIER ID