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General NPI Number Information
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NPI Number | 1245843556
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Entity Type | Organization
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Legal Business Name | MOBILE XRAY DIAGNOSTICS LLC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 350 BEDFORD ST STE 5A
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City | LAKEVILLE
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State | MA
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Zip | 02347-2128
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Country | US
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Telephone | 774-213-9729
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Fax | 508-813-3137
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Provider Business Mailing Address
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Address Line | 350 BEDFORD ST STE 5A
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City | LAKEVILLE
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State | MA
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Zip | 02347-2128
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Country | US
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Telephone | 774-213-9729
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Fax | 508-813-3137
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | PATRICIA L TORTORELLA
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Credential |
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Telephone | 774-213-9729
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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 |
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