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General NPI Number Information
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NPI Number | 1023187572
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC IMAGING CONSULTANTS OF ST PETERSBURG PA
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 5136 CENTRAL AVE
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City | ST PETERSBURG
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State | FL
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Zip | 33707
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Country | US
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Telephone | 727-579-2500
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Fax | 727-579-3433
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Provider Business Mailing Address
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Address Line | 5136 CENTRAL AVENUE
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City | ST PETERSBURG
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State | FL
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Zip | 33707
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Country | US
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Telephone | 727-579-2500
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Fax | 727-579-3433
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY SCOTT THORPE
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Credential | DC DACBR
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Telephone | 727-579-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0200X
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Taxonomy Name | Radiology Chiropractor
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License Number | 41235
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License Number State | FL
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