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General NPI Number Information
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NPI Number | 1588105423
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Entity Type | Organization
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Legal Business Name | ROYALTECH, LLC
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Dates
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Enumeration Date | 03/11/2017
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Last Update Date | 03/11/2017
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Provider Practice Location Address
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Address Line | 1703 E CACHE LA POUDRE ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-4613
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Country | US
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Telephone | 719-646-8056
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 E CACHE LA POUDRE ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-4613
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RADIOLOGIC TECHNOLOGIST
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Name | JONATHAN BRUCE
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Credential |
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Telephone | 719-646-8056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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