Healthcare Provider Details

I. General information

NPI: 1417257114
Provider Name (Legal Business Name): NEW FRONTIER IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 COMMERCIAL WAY STE. 10
ROCK SPRINGS WY
82901-4755
US

IV. Provider business mailing address

PO BOX 2148
ROCK SPRINGS WY
82902-2148
US

V. Phone/Fax

Practice location:
  • Phone: 307-371-0577
  • Fax:
Mailing address:
  • Phone: 913-642-4900
  • Fax: 913-381-0979

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: MARIA STRADLEY
Title or Position: CEO
Credential:
Phone: 307-371-0577