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General NPI Number Information
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NPI Number | 1396791984
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Entity Type | Organization
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Legal Business Name | WEST CENTRAL RADIOLOGICAL ASSOCIATES, LTD
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 1101 1ST ST S STE 5 WEST CENTRAL RADIOLOGICAL ASSOCIATES, LTD
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City | WILLMAR
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State | MN
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Zip | 56201-3500
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Country | US
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Telephone | 320-262-3344
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Fax | 320-262-3347
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Provider Business Mailing Address
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Address Line | 1101 1ST ST S STE 5 WEST CENTRAL RADIOLOGICAL ASSOCIATES, LTD
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City | WILLMAR
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State | MN
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Zip | 56201-3500
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Country | US
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Telephone | 320-262-3344
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Fax | 320-262-3347
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARRY OSTBY SEWALL
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Credential | MD
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Telephone | 320-262-3344
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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 | 207
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License Number State | MN
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