Healthcare Provider Details
I. General information
NPI: 1649312984
Provider Name (Legal Business Name): MEDICAL INNOVATIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1015 E RING RD
IRONTON OH
45638-9610
US
IV. Provider business mailing address
1015 E RING RD
IRONTON OH
45638-9610
US
V. Phone/Fax
- Phone: 740-532-1100
- Fax: 740-532-7125
- Phone: 740-532-1100
- Fax: 740-532-7125
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
BALLARD
Title or Position: MANAGER
Credential: DC
Phone: 740-532-1100