Healthcare Provider Details

I. General information

NPI: 1225105430
Provider Name (Legal Business Name): CAROL A MACLEAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 FRIENDLY LN
ASHEVILLE NC
28806-4704
US

IV. Provider business mailing address

101 FRIENDLY LN
ASHEVILLE NC
28806-4704
US

V. Phone/Fax

Practice location:
  • Phone: 828-271-4949
  • Fax: 206-203-4697
Mailing address:
  • Phone: 828-271-4949
  • Fax: 206-203-4697

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: CAROL ANN MACLEAN
Title or Position: OWNER SONOGRAPHER
Credential: ARDMS AB OB RVT RT
Phone: 828-271-4949