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General NPI Number Information
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NPI Number | 1437289600
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Entity Type | Organization
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Legal Business Name | BRIGHT HORIZON IMAGING LLC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3635 BRASELTON HWY SUITE A
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City | DACULA
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State | GA
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Zip | 30019-1068
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Country | US
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Telephone | 866-860-2576
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Fax | 770-771-6931
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Provider Business Mailing Address
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Address Line | 3635 BRASELTON HWY SUITE A
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City | DACULA
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State | GA
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Zip | 30019-1068
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Country | US
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Telephone | 770-771-6930
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Fax |
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Authorized Official
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Title or Position | TECHNICAL DIRECTOR
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Name | CALVIN FERRIER
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Credential |
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Telephone | 866-860-2576
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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 | GA
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