Healthcare Provider Details

I. General information

NPI: 1346461100
Provider Name (Legal Business Name): MOBILE ULTRASOUND SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2913 SW BRIDLEWOOD CIR
LEES SUMMIT MO
64081-2473
US

IV. Provider business mailing address

2913 SW BRIDLEWOOD CIR
LEES SUMMIT MO
64081-2473
US

V. Phone/Fax

Practice location:
  • Phone: 816-500-7130
  • Fax:
Mailing address:
  • Phone: 816-500-7130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number72262
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number72262
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number72262
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number72262
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number72262
License Number State

VIII. Authorized Official

Name: MRS. ALICE DALE MARTIN
Title or Position: OWNER ,OPERATOR
Credential: RDMS, RVT
Phone: 816-500-7130