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General NPI Number Information
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NPI Number | 1558338996
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Entity Type | Organization
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Legal Business Name | NORTHERN IMAGING OF DULUTH LLC
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 930 E 2ND ST
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City | DULUTH
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State | MN
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Zip | 55805
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Country | US
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Telephone | 218-722-5390
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Fax | 218-722-7501
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Provider Business Mailing Address
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Address Line | PO BOX 1450 NW 7612
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City | MINNEAPOLIS
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State | MN
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Zip | 55485-7612
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Country | US
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Telephone | 218-722-5390
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Fax | 218-722-7501
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Authorized Official
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Title or Position | OFFICER (CFO)
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Name | JAMES F. STANLEY
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Credential |
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Telephone | 952-543-6504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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