Healthcare Provider Details

I. General information

NPI: 1396795969
Provider Name (Legal Business Name): ACOUSTIC IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 MCLEOD DR STE 140
LAS VEGAS NV
89120-4049
US

IV. Provider business mailing address

6230 MCLEOD DR STE 140
LAS VEGAS NV
89120-4049
US

V. Phone/Fax

Practice location:
  • Phone: 702-435-9478
  • Fax: 702-736-2199
Mailing address:
  • Phone: 702-435-9478
  • Fax: 702-736-2199

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: MS. TONYA D DUBIN
Title or Position: OWNER
Credential:
Phone: 702-435-9478