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General NPI Number Information
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NPI Number | 1598323073
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Entity Type | Organization
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Legal Business Name | WISCONSIN MOBILE IMAGING INC.
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 234 W FLORIDA ST STE 209
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City | MILWAUKEE
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State | WI
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Zip | 53204-1659
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Country | US
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Telephone | 414-755-2205
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Fax | 866-798-0191
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Provider Business Mailing Address
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Address Line | 234 W FLORIDA ST STE 209
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City | MILWAUKEE
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State | WI
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Zip | 53204-1659
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Country | US
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Telephone | 414-755-2205
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Fax | 866-798-0191
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Authorized Official
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Title or Position | CEO
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Name | JAMES M DRURY
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Credential |
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Telephone | 925-915-6384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0207X
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Taxonomy Name | Mobile Mammography Clinic/Center
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License Number |
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License Number State |
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