Healthcare Provider Details

I. General information

NPI: 1730619289
Provider Name (Legal Business Name): INJURY IMAGING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 06/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 E MCKELLIPS RD STE 103
MESA AZ
85203-2721
US

IV. Provider business mailing address

173 MAIN ST
THOMASTON ME
04861-3807
US

V. Phone/Fax

Practice location:
  • Phone: 480-644-9878
  • Fax: 480-644-9879
Mailing address:
  • Phone: 207-354-5089
  • Fax: 877-422-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARTIN FARRELL
Title or Position: CEO
Credential:
Phone: 207-706-6810