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General NPI Number Information
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NPI Number | 1326058645
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Entity Type | Organization
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Legal Business Name | SMART CHOICE MRI LLC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 1621 MILLER PARK WAY
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City | WEST MILWAUKEE
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State | WI
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Zip | 53214-3605
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Country | US
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Telephone | 414-431-0309
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Fax | 414-672-2292
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Provider Business Mailing Address
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Address Line | 10532 NORTH PORT WASHINGTON ROAD SUITE 1B
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City | MEGQUON
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State | WI
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Zip | 53092
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Country | US
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Telephone | 414-431-0309
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Fax | 414-672-2292
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Authorized Official
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Title or Position | VP, OPERATIONS
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Name | CHRISTINE M HERBST
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Credential |
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Telephone | 414-807-5733
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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 | WI
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