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General NPI Number Information
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NPI Number | 1477351815
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Entity Type | Organization
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Legal Business Name | WELLNESS IMAGING
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1101 VILLAGE WALK
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City | COVINGTON
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State | LA
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Zip | 70433-4006
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Country | US
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Telephone | 504-657-8865
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Fax |
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Provider Business Mailing Address
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Address Line | 748 CARONDELET ST
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City | MANDEVILLE
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State | LA
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Zip | 70448-5007
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Country | US
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Telephone | 504-657-8865
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Fax |
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Authorized Official
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Title or Position | SONOGRAPHER/OWNER
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Name | CHERI BORGSTEDE
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Credential | ARDMS RVT
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Telephone | 504-657-8865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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