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General NPI Number Information
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NPI Number | 1386895274
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Entity Type | Organization
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Legal Business Name | INTEGRAL SCAN
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 9442 S MAIN ST STE 118
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City | JONESBORO
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State | GA
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Zip | 30236-6073
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Country | US
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Telephone | 770-478-3700
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Fax | 770-478-3300
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Provider Business Mailing Address
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Address Line | 9442 S MAIN ST STE 118
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City | JONESBORO
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State | GA
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Zip | 30236-6073
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Country | US
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Telephone | 770-478-3700
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Fax | 770-478-3300
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Authorized Official
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Title or Position | SONOGRAPHER
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Name | MRS. LINDA B. TURNER
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Credential | RDMS
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Telephone | 770-478-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 33484
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License Number State | GA
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