Definitive Neurodiagnostics, LLC Technical Services

NPI #1134519051 in Normal, Illinois

Provider Information

NPI Number: 1134519051
Entity Type: Organization
Organization Name: Definitive Neurodiagnostics, LLC Technical Services
Subpart: Yes (part of a larger organization)
Parent Organization: DEFINITIVE NEURODIAGNOSTICS, LLC
Primary Specialty: Specialist/Technologist, Other - Electroneurodiagnostic
Enumeration Date: Jan 30, 2015
Last Updated: Jan 30, 2015

Practice Location

Address: 1604 VISA DR # 1
City: Normal
State: Illinois
ZIP Code: 61761-2195
Phone: (309) 454-1100

Authorized Official

Name: DR. JOHN ATWATER, M.D.
Title: OWNER
Phone: (309) 454-1100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist, Other - Electroneurodiagnostic — Electroneurodiagnostic	246ZE0600X	Primary

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