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General NPI Number Information
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NPI Number | 1063807626
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Entity Type | Organization
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Legal Business Name | CLEARVIEW ULTRASOUND INC.
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 16670 USTICK RD
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City | CALDWELL
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State | ID
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Zip | 83607-9611
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Country | US
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Telephone | 208-724-3318
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Fax | 208-453-2131
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Provider Business Mailing Address
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Address Line | 16670 USTICK RD
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City | CALDWELL
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State | ID
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Zip | 83607-9611
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Country | US
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Telephone | 208-724-3318
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Fax | 208-453-2131
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. DARCI CAYWOOD
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Credential | BSRT RT(R) RDMS RVT
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Telephone | 208-724-3318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | 109245
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License Number State | ID
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