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General NPI Number Information
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NPI Number | 1326645813
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Entity Type | Organization
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Legal Business Name | LUMINA IMAGING
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 8401 MENTOR AVE STE B
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City | MENTOR
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State | OH
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Zip | 44060-5843
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Country | US
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Telephone | 440-592-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 8401 MENTOR AVE STE B
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City | MENTOR
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State | OH
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Zip | 44060-5843
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR LUMINA IMAGING
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Name | BRYAN CROWLEY
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Credential |
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Telephone | 440-592-6109
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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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