Healthcare Provider Details

I. General information

NPI: 1669417911
Provider Name (Legal Business Name): COMPUTERIZED MEDICAL IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 W HAMILTON AVE STE B
EAU CLAIRE WI
54701-6968
US

IV. Provider business mailing address

PO BOX 1426
EAU CLAIRE WI
54702-1426
US

V. Phone/Fax

Practice location:
  • Phone: 715-839-8020
  • Fax: 715-839-7440
Mailing address:
  • Phone: 715-838-8898
  • Fax: 715-838-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471B0102X
TaxonomyBone Densitometry Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code2471M2300X
TaxonomyMammography Radiologic Technologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2471N0900X
TaxonomyNuclear Medicine Technology Radiologic Technologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL STANGL
Title or Position: PRESIDENT
Credential:
Phone: 715-839-8020