Healthcare Provider Details

I. General information

NPI: 1750561726
Provider Name (Legal Business Name): WOMENS IMAGING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1684 S HORNER BLVD
SANFORD NC
27330-5634
US

IV. Provider business mailing address

1684 S HORNER BLVD
SANFORD NC
27330-5634
US

V. Phone/Fax

Practice location:
  • Phone: 919-718-5333
  • Fax: 919-776-3746
Mailing address:
  • Phone: 919-718-5333
  • Fax: 919-776-3746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOY YOW REECE
Title or Position: OWNER
Credential:
Phone: 919-718-5333