MEDICARE: CORINE R STRICKLAND R.T. (R) (CT) (MR)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247100000X	Radiologic Technologist	524133	NC
2	2471C3401X	Computed Tomography Radiologic Technologist	524133	NC
3	2471C3402X	Radiography Radiologic Technologist	524133	NC
4	2471M1202X	Magnetic Resonance Imaging Radiologic Technologist	524133	NC

General Provider Information

NPI Number	:	1861091498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINE R STRICKLAND R.T. (R) (CT) (MR)

Provider Business Mailing Address
First Line	:	1016 N BROADRIDGE RD
Second Line	:
City	:	ORRUM
State	:	NC
Zip	:	28369
Country	:	US
Telephone Number	:	910-736-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 N BROADRIDGE RD
Second Line	:
City	:	ORRUM
State	:	NC
Zip	:	28369
Country	:	US
Telephone Number	:	910-736-0580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2020
Last Update Date	:	10/24/2020

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