Basic Information
Provider Information
NPI: 1386007144
EntityType: 2
ReplacementNPI:  
OrganizationName: NEURO WORKS INC
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Mailing Information
Address1: PO BOX 17809
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322457809
CountryCode: US
TelephoneNumber: 9047235665
FaxNumber: 9043380951
Practice Location
Address1: 1210 KINGSLEY AVE STE 1
Address2:  
City: ORANGE PARK
State: FL
PostalCode: 320734615
CountryCode: US
TelephoneNumber: 9042761663
FaxNumber: 9042762469
Other Information
ProviderEnumerationDate: 03/30/2016
LastUpdateDate: 03/30/2016
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: GUTHRIE
AuthorizedOfficialFirstName: SCOTT
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 9042762577
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QS1200X  Y Ambulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic

No ID Information.


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