| Comprehensive Neuropsychological Services Pc | |
|
7320 Garden Ln Portage MI 49002-4423 | |
| (269) 217-2992 | |
| (269) 324-7707 |
| Full Name | Comprehensive Neuropsychological Services Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 7320 Garden Ln, Portage, Michigan |
| Authorized Official Name and Position | Ennis Berker (PRESIDENT) |
| Authorized Official Contact | 2692172992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Neuropsychological Services Pc 7320 Garden Ln Portage MI 49002-4423 Ph: () - | Comprehensive Neuropsychological Services Pc 7320 Garden Ln Portage MI 49002-4423 Ph: (269) 217-2992 |
| NPI Number | 1740549120 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 05/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740549120 | NPI | - | NPPES |
| 0M0-9810 | Other | MI | MEDICARE PART B |
| 680C945730 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 6301006050 (Michigan) | Primary |
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