Provider Demographics
NPI:1457563371
Name:WESTERN STATES NEUROMONITORING SERVICES, LLC
Entity Type:Organization
Organization Name:WESTERN STATES NEUROMONITORING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:AUGUST
Authorized Official - Last Name:WIECHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:719-596-6110
Mailing Address - Street 1:5390 N ACADEMY BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918
Mailing Address - Country:US
Mailing Address - Phone:719-596-6110
Mailing Address - Fax:719-596-6112
Practice Address - Street 1:5390 N ACADEMY BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:719-596-6110
Practice Address - Fax:719-596-6112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty