Healthcare Provider Details

I. General information

NPI: 1255518619
Provider Name (Legal Business Name): MOBILE SONOGRAPHERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 E HARRIET LEA ST
SIOUX FALLS SD
57103
US

IV. Provider business mailing address

PO BOX 463
SIOUX FALLS SD
57101-0463
US

V. Phone/Fax

Practice location:
  • Phone: 605-940-1419
  • Fax: 605-336-6558
Mailing address:
  • Phone: 605-940-1419
  • Fax: 605-336-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number StateSD

VIII. Authorized Official

Name: MS. LEE A ENGELBRECHT
Title or Position: MANAGER
Credential: RVT
Phone: 605-940-1419