Healthcare Provider Details

I. General information

NPI: 1316984719
Provider Name (Legal Business Name): OPENSIDED MRI OF CLEVELAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30400 DETROIT RD SUITE 30
WESTLAKE OH
44145
US

IV. Provider business mailing address

30400 DETROIT RD SUITE 30
WESTLAKE OH
44145
US

V. Phone/Fax

Practice location:
  • Phone: 888-808-6736
  • Fax: 440-808-0289
Mailing address:
  • Phone: 888-808-6736
  • Fax: 440-808-0289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: LINDA RHODES
Title or Position: OFFICER TREASURER
Credential:
Phone: 804-217-7114