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General NPI Number Information
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NPI Number | 1063758506
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Entity Type | Organization
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Legal Business Name | MOBILE ULTRASOUND LLC
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Dates
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Enumeration Date | 01/02/2013
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 3388 FOUNDERS RD SUITE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1443
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Country | US
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Telephone | 317-471-8553
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Fax | 888-288-6070
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Provider Business Mailing Address
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Address Line | 3319 N ELSTON AVE SUITE 252
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City | CHICAGO
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State | IL
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Zip | 60618-5811
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Country | US
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Telephone | 317-471-8553
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Fax | 888-288-6070
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Authorized Official
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Title or Position | BRANCH MANAGER
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Name | MS. NICOLE DAVIS
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Credential |
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Telephone | 317-682-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XC2903X
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Taxonomy Name | Vascular Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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