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General NPI Number Information
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NPI Number | 1144311473
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Entity Type | Organization
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Legal Business Name | KINETIC IMAGING, INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 45 SPRINT DR
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City | CARLISLE
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State | PA
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Zip | 17013-7696
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Country | US
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Telephone | 717-960-3313
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Fax | 717-690-3301
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Provider Business Mailing Address
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Address Line | 4520 UNION DEPOSIT RD
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City | HARRISBURG
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State | PA
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Zip | 17111-2910
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Country | US
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Telephone | 717-652-6105
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Fax | 717-652-2465
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | CHRISTOPHER LADD
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Credential | M.D.
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Telephone | 717-960-3313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD047428L
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License Number State | PA
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