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General NPI Number Information
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NPI Number | 1689854705
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Entity Type | Organization
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Legal Business Name | 1080 INVESTMENTS, LLC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 2612 NEEDMORE RD
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City | DAYTON
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State | OH
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Zip | 45414-4206
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Country | US
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Telephone | 317-557-6165
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Fax |
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Provider Business Mailing Address
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Address Line | 2612 NEEDMORE RD
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City | DAYTON
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State | OH
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Zip | 45414-4206
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Country | US
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Telephone | 317-557-6165
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEVE J GANOTE
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Credential |
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Telephone | 317-557-6165
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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 | 06M113001
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License Number State | OH
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