Provider Demographics
NPI:1881864031
Name:NEURIOM, LLC
Entity Type:Organization
Organization Name:NEURIOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-588-4845
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:MILAM
Mailing Address - State:TX
Mailing Address - Zip Code:75959-0116
Mailing Address - Country:US
Mailing Address - Phone:225-588-4845
Mailing Address - Fax:303-459-5180
Practice Address - Street 1:607 10TH STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401
Practice Address - Country:US
Practice Address - Phone:225-588-4845
Practice Address - Fax:303-459-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty