Clinical Neurophysiology Consulting PLLC
Psychiatry & Neurology, Neurology in Grand Rapids, MI. Organization (NPI-2).
NPI number1497487524
StatusActive
Last updated in NPPESJun 28, 2022
Details
- NPI
- 1497487524
- Entity type
- Organization (NPI-2)
- Legal business name
- Clinical Neurophysiology Consulting PLLC
- Organization subpart
- No
- Enumeration date
- Jun 28, 2022
- Certification date
- Jun 28, 2022
- Last updated
- Jun 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | – | – | Yes |
Practice location
160 Campau Cir Nw Unit 151Grand Rapids, MI 49503-6100
Phone 313-977-0217
Mailing address
160 Campau Cir Nw Unit 151Grand Rapids, MI 49503-6100
Phone 313-977-0217
Authorized official
David Edwin Burdette
President
3139770217
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