Provider Demographics
NPI:1841547395
Name:INTRA-OPERATIVE MONITORING INNOVATIONS
Entity type:Organization
Organization Name:INTRA-OPERATIVE MONITORING INNOVATIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CERAT
Authorized Official - Phone:801-706-2634
Mailing Address - Street 1:PO BOX 5757
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83303-5757
Mailing Address - Country:US
Mailing Address - Phone:801-706-2634
Mailing Address - Fax:208-324-1906
Practice Address - Street 1:1376 FILLMORE STREET PMB 5757
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83303-5757
Practice Address - Country:US
Practice Address - Phone:801-706-2634
Practice Address - Fax:208-324-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty