Provider Demographics
NPI:1699100933
Name:NEUROLOGIC, LLC
Entity type:Organization
Organization Name:NEUROLOGIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:OREMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-888-4384
Mailing Address - Street 1:10940 S PARKER RD STE 503
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7440
Mailing Address - Country:US
Mailing Address - Phone:877-446-4945
Mailing Address - Fax:866-897-0799
Practice Address - Street 1:10940 S PARKER RD STE 503
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7440
Practice Address - Country:US
Practice Address - Phone:877-446-4945
Practice Address - Fax:866-897-0799
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEUROLOGIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-05
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty