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General NPI Number Information
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NPI Number | 1417768425
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Entity Type | Organization
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Legal Business Name | MH IMAGING - LA CROSSE
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 2402 LA CROSSE ST
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City | LA CROSSE
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State | WI
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Zip | 54601-3836
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Country | US
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Telephone | 608-829-8299
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Fax |
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Provider Business Mailing Address
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Address Line | 2402 LA CROSSE ST
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City | LA CROSSE
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State | WI
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Zip | 54601-3836
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Country | US
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Telephone | 608-829-8299
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | CHRISTINA WIPPERFURTH
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Credential |
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Telephone | 608-829-8299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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