Healthcare Provider Details
I. General information
NPI: 1366906877
Provider Name (Legal Business Name): DIAGNOSTIC SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2019
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1113 LINCOLN PARK RD
SPRINGFIELD KY
40069-9573
US
IV. Provider business mailing address
PO BOX 128
SPRINGFIELD KY
40069-0128
US
V. Phone/Fax
- Phone: 859-481-5830
- Fax: 859-481-9004
- Phone: 859-481-5830
- Fax: 859-481-9004
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251E1300X |
| Taxonomy | Clinical Electrophysiology Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANA
CONNOR-ISRAEL
Title or Position: BUSINESS MANAGER/OWNER
Credential:
Phone: 859-481-5830