Healthcare Provider Details

I. General information

NPI: 1134088719
Provider Name (Legal Business Name): DYNAMIC IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 YORK WOODS RD
SOUTH BERWICK ME
03908-2100
US

IV. Provider business mailing address

167 YORK WOODS RD
SOUTH BERWICK ME
03908-2100
US

V. Phone/Fax

Practice location:
  • Phone: 207-408-3833
  • Fax:
Mailing address:
  • Phone: 207-408-3833
  • 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 State

VIII. Authorized Official

Name: JENNIFER R KNOWLES
Title or Position: OWNER
Credential: R.D.M.S
Phone: 207-408-3833