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General NPI Number Information
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NPI Number | 1528079316
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Entity Type | Organization
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Legal Business Name | SILVER BULLET SCANNING SERVICE LLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 1501 W STEPHENSON AVE
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City | HARRISON
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State | AR
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Zip | 72601-3915
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Country | US
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Telephone | 870-715-2802
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Fax | 870-741-6853
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Provider Business Mailing Address
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Address Line | 1501 W STEPHENSON AVE
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City | HARRISON
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State | AR
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Zip | 72601-3915
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Country | US
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Telephone | 870-715-2802
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Fax | 870-741-6853
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Authorized Official
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Title or Position | OWNER
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Name | MR. LARRY L. HORTON
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Credential | RDMS/RVT/RDCS
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Telephone | 870-715-2802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number | 10541
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License Number State | AR
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