Organization · NPI-2

Ahv Iom LLC

Electrodiagnostic Medicine · Ft Worth, TX

NPI number1942849161
StatusActive
Last updated in NPPESJan 6, 2020

Details

NPI
1942849161
Entity type
Organization (NPI-2)
Legal business name
Ahv Iom LLC
Organization subpart
No
Enumeration date
Jan 6, 2020
Certification date
Jan 6, 2020
Last updated
Jan 6, 2020

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 Sullivan
Billing Manager
8175298488

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