MEDICARE: BONNIE KRALOVETZ RDCS

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	246XS1301X	Sonography Specialist/Technologist Cardiovascular	92953

General Provider Information

NPI Number	:	1891998324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE KRALOVETZ RDCS

Provider Business Mailing Address
First Line	:	2119 AUSTRIAN WAY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-3424
Country	:	US
Telephone Number	:	920-254-6666
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 AUSTRIAN WAY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-3424
Country	:	US
Telephone Number	:	920-254-6666
Fax Number	:

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

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	07/08/2007

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