Organization · NPI-2

Atl Perimeter Intraoperative Monitoring LLC

Electrodiagnostic Medicine · Ft Worth, TX

NPI number1205507035
StatusActive
Last updated in NPPESSep 22, 2021

Details

NPI
1205507035
Entity type
Organization (NPI-2)
Legal business name
Atl Perimeter Intraoperative Monitoring LLC
Organization subpart
No
Enumeration date
Sep 22, 2021
Certification date
Sep 22, 2021
Last updated
Sep 22, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
204R00000X Electrodiagnostic Medicine––Yes

Practice location

111 Boland St Ste 211
Ft Worth, TX 76107-1265

Phone 817-529-8488 · Fax 903-328-6568

Mailing address

111 Boland St Ste 211
Ft Worth, TX 76107-1265

Phone 817-529-8488

Authorized official

Gina M Sullivan
Practice Administrator
9032590550

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