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General NPI Number Information
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NPI Number | 1093175838
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Entity Type | Organization
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Legal Business Name | PRECISION ULTRASOUND IMAGING INC.
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 730 RIDGEWOOD RD STE B
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City | RIDGELAND
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State | MS
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Zip | 39157-4434
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Country | US
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Telephone | 601-573-0577
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Fax | 601-939-6775
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Provider Business Mailing Address
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Address Line | 730 RIDGEWOOD RD STE B
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City | RIDGELAND
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State | MS
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Zip | 39157-4434
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Country | US
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Telephone | 601-573-0577
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Fax | 601-939-6775
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MELISSA BATES KELLEY
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Credential | RT RDMS RVT
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Telephone | 601-573-0577
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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 | 25X0009816
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License Number State | MS
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