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General NPI Number Information
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NPI Number | 1548713506
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Entity Type | Organization
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Legal Business Name | SMART CHOICE MRI, LLC
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 10532 N PORT WASHINGTON RD SUITE 1B
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City | MEQUON
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State | WI
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Zip | 53092-5563
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Country | US
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Telephone | 844-633-3674
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Fax | 414-672-2292
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Provider Business Mailing Address
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Address Line | 1605 QUEENS DRIVE SUITE 130
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City | WOODBURY
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State | MN
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Zip | 55125-1740
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Country | US
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Telephone | 844-633-3674
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Fax | 414-672-2292
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD ANDERSON
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Credential |
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Telephone | 844-633-3674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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