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General NPI Number Information
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NPI Number | 1104554971
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Entity Type | Organization
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Legal Business Name | WYOMISSING OPEN MRI, LLC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 55 COMMERCE DR
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City | WYOMISSING
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State | PA
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Zip | 19610-1038
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Country | US
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Telephone | 610-477-1950
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Fax | 610-477-1940
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Provider Business Mailing Address
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Address Line | 55 COMMERCE DR
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City | WYOMISSING
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State | PA
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Zip | 19610-1038
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Country | US
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Telephone | 610-477-1950
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Fax | 610-477-1940
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | BRUCE MILLER
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Credential |
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Telephone | 610-477-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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