Healthcare Provider Details

I. General information

NPI: 1457384059
Provider Name (Legal Business Name): MOBILE SOUND IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 N 400 W
LINDON UT
84042
US

IV. Provider business mailing address

PO BOX 700
PLEASANT GROVE UT
84062-0700
US

V. Phone/Fax

Practice location:
  • Phone: 801-376-9797
  • Fax:
Mailing address:
  • Phone: 801-376-9797
  • Fax: 801-785-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOY LEE
Title or Position: CEO
Credential:
Phone: 801-376-9797