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General NPI Number Information
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NPI Number | 1598804635
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Entity Type | Organization
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Legal Business Name | IMAGING DIAGNOSTICS IN MOTION LLC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 25 BARTLEY HILL RD
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City | LONDONDERRY
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State | NH
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Zip | 03053-2427
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Country | US
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Telephone | 603-437-9621
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Fax |
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Provider Business Mailing Address
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Address Line | 35 MANCHESTER RD SUITE 11A, PMB 113
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City | DERRY
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State | NH
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Zip | 03038-3064
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Country | US
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Telephone | 603-437-9621
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Fax | 866-265-3113
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. CHRISTOPHER BRISTOL
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Credential | RDCS RVS CCT
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Telephone | 603-437-9621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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