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General NPI Number Information
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NPI Number | 1295204253
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Entity Type | Organization
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Legal Business Name | EASY IMAGING, LLC
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 16100 19 MILE RD STE X
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1148
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Country | US
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Telephone | 586-477-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 16100 19 MILE RD STE 800
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1148
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Country | US
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Telephone | 586-477-1580
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Fax | 586-477-1232
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Authorized Official
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Title or Position | BILLING ADMINISTRATOR
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Name | ALICIA ROSE AMBROZY
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Credential |
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Telephone | 586-477-1580
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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 |
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License Number State |
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