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General NPI Number Information
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NPI Number | 1184689267
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Entity Type | Organization
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Legal Business Name | PRECISE ULTRASOUND INC
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 2005 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-5836
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Country | US
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Telephone | 941-708-9200
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Fax | 941-708-9888
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Provider Business Mailing Address
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Address Line | 2005 MANATEE AVE WEST
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City | BRADENTON
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State | FL
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Zip | 34205
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Country | US
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Telephone | 941-708-9200
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Fax | 941-708-9888
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. ERNIE CARL LISCH
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Credential |
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Telephone | 941-708-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | HCC5605
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License Number State | FL
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