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General NPI Number Information
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NPI Number | 1598700965
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Entity Type | Organization
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Legal Business Name | OPEN MRI JASPER, LLC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 12/28/2012
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Provider Practice Location Address
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Address Line | 301 N WALSTON BRIDGE RD
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City | JASPER
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State | AL
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Zip | 35504-8648
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Country | US
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Telephone | 205-387-0977
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N WALSTON BRIDGE RD
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City | JASPER
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State | AL
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Zip | 35504-8648
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Country | US
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Telephone | 205-387-0977
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | HOLLY F CARTER
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Credential |
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Telephone | 205-991-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 000239
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License Number State | AL
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