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General NPI Number Information
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NPI Number | 1043863525
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Entity Type | Organization
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Legal Business Name | MOBILITY DX, LLC
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 1372 MEADOW CREST DR
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7413
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Country | US
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Telephone | 408-373-6176
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Fax |
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Provider Business Mailing Address
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Address Line | 1372 MEADOW CREST DR
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7413
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Country | US
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Telephone | 408-373-6176
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Fax |
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Authorized Official
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Title or Position | OWNER/TECHNOLOGIST
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Name | LLOYD M JONES
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Credential | RT (R) (CT) (CIIP)
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Telephone | 408-373-6176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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