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General NPI Number Information
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NPI Number | 1477624252
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Entity Type | Organization
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Legal Business Name | DOUBLE IMAGE, INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/31/2007
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Provider Practice Location Address
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Address Line | 3001 WHITE BEAR AVE N SUITE 1050
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City | SAINT PAUL
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State | MN
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Zip | 55109-1215
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Country | US
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Telephone | 651-770-3923
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Fax | 651-770-5316
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Provider Business Mailing Address
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Address Line | PO BOX 241509
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City | APPLE VALLEY
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State | MN
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Zip | 55124-1509
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Country | US
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Telephone | 952-435-2662
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Fax | 952-435-2624
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHANNIE L KELLER
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Credential |
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Telephone | 952-435-2662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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