Healthcare Provider Details

I. General information

NPI: 1871735209
Provider Name (Legal Business Name): PARTNERS IN 3D IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2009
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 DEAN AVE SE
ROME GA
30161-6602
US

IV. Provider business mailing address

2000 DEAN AVE SE
ROME GA
30161-6602
US

V. Phone/Fax

Practice location:
  • Phone: 706-291-2526
  • Fax:
Mailing address:
  • Phone: 706-291-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number StateGA

VIII. Authorized Official

Name: MR. EDDIE RIVERS
Title or Position: DIRECTOR
Credential:
Phone: 706-378-0611