Healthcare Provider Details

I. General information

NPI: 1811323637
Provider Name (Legal Business Name): DRY CREEK IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5214 MARYLAND WAY STE 200
BRENTWOOD TN
37027-5034
US

IV. Provider business mailing address

1007 E COLFAX AVE
DENVER CO
80218-1916
US

V. Phone/Fax

Practice location:
  • Phone: 615-661-9200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN C RICE JR.
Title or Position: CEO
Credential:
Phone: 615-661-9200