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General NPI Number Information
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NPI Number | 1215316435
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Entity Type | Organization
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Legal Business Name | JLM X-RAY LLC
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 1015 CANTON STREET
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City | ROSWELL
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State | GA
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Zip | 30075
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Country | US
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Telephone | 770-993-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 22 GREENE STREET
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City | ROSWELL
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State | GA
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Zip | 30075
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Country | US
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Telephone | 770-993-4545
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN SMITH
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Credential |
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Telephone | 770-554-8989
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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 |
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License Number State | GA
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