Basic Information
| Provider Information | |||||||||
| NPI: | 1487225835 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | MAY | ||||||||
| FirstName: | JASON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4600 S ULSTER ST STE 1225 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802372696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7202873093 | ||||||||
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| Address1: | 4600 S ULSTER ST STE 1225 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802372696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7202873093 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2021 | ||||||||
| LastUpdateDate: | 07/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZE0600X | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic |
No ID Information.