NPI 1831577139
Arizona Iom LLC
Practice location
- Address
- 2301 West Sanoque Court, Gilbert, AZ 85298
- Phone
- (720) 503-5711
- Mailing address
- 2907 Shelter Island Dr. Suite 105-612, San Diego, CA 92106-2743
Authorised official
- Name
- Matthew L. Fordyce
- Title
- Managing Partner
- Phone
- (619) 458-6306
Registered specialties
Electroneurodiagnostic Specialist/Technologist
Primary
Registry record
- NPI
- 1831577139
- Entity type
- Organization
- NPI issued
- 7 May 2015
- Record last updated
- 10 Oct 2018
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.