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General NPI Number Information
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NPI Number | 1073802682
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Entity Type | Organization
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Legal Business Name | UPPER CUMBERLAND MOBILE IMAGING, LLC
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 291 LAKE LN
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City | COOKEVILLE
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State | TN
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Zip | 38506-7936
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Country | US
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Telephone | 931-267-0901
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Fax |
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Provider Business Mailing Address
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Address Line | 291 LAKE LN
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City | COOKEVILLE
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State | TN
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Zip | 38506-7936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ULTRASONOGRAPHER
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Name | JESSIE HITCHCOCK
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Credential |
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Telephone | 931-267-0901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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