Healthcare Provider Details
I. General information
NPI: 1326094111
Provider Name (Legal Business Name): ACOUSTIC IMAGING , INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6230 MCLEOD DR # 140
LAS VEGAS NV
89120-4049
US
IV. Provider business mailing address
6230 MCLEOD DR # 140
LAS VEGAS NV
89120-4049
US
V. Phone/Fax
- Phone: 702-736-2999
- Fax: 702-736-2199
- Phone: 702-736-2999
- Fax: 702-736-2199
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | MP00257 |
| License Number State | NV |
VIII. Authorized Official
Name: MS.
TONYA
DUBIN
Title or Position: OWNER
Credential:
Phone: 702-736-2999