Healthcare Provider Details

I. General information

NPI: 1477351815
Provider Name (Legal Business Name): WELLNESS IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VILLAGE WALK
COVINGTON LA
70433-4006
US

IV. Provider business mailing address

748 CARONDELET ST
MANDEVILLE LA
70448-5007
US

V. Phone/Fax

Practice location:
  • Phone: 504-657-8865
  • Fax:
Mailing address:
  • Phone: 504-657-8865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: CHERI BORGSTEDE
Title or Position: SONOGRAPHER/OWNER
Credential: ARDMS RVT
Phone: 504-657-8865