Provider Demographics
NPI:1760675425
Name:VESTIBULAR DIAGNOSICS, LLC
Entity Type:Organization
Organization Name:VESTIBULAR DIAGNOSICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GARGANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-498-9723
Mailing Address - Street 1:6001 COCHRAN RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-3310
Mailing Address - Country:US
Mailing Address - Phone:440-498-9723
Mailing Address - Fax:440-498-9725
Practice Address - Street 1:4400 ROCKSIDE RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2109
Practice Address - Country:US
Practice Address - Phone:440-498-9723
Practice Address - Fax:440-498-9725
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VESTIBULAR DIAGNOSTICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-24
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory