Healthcare Provider Details

I. General information

NPI: 1003976176
Provider Name (Legal Business Name): SONO TECH ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 6TH ST
GRETNA LA
70053-6039
US

IV. Provider business mailing address

PO BOX 24447
NEW ORLEANS LA
70184-4447
US

V. Phone/Fax

Practice location:
  • Phone: 504-228-9895
  • Fax:
Mailing address:
  • Phone: 504-228-9895
  • Fax: 504-355-1041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY GILLEN
Title or Position: PRESIDENT
Credential:
Phone: 504-228-9895