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General NPI Number Information
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NPI Number | 1710840905
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Entity Type | Organization
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Legal Business Name | WELLINGTON DIAGNOSTIC ULTRASOUND IMAGING LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | G3500 FLUSHING RD STE 104
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City | FLINT
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State | MI
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Zip | 48504-4247
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Country | US
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Telephone | 469-269-4986
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7087
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City | FLINT
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State | MI
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Zip | 48507-0087
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Country | US
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Telephone | 469-269-4986
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANDRA HOUSTON
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Credential |
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Telephone | 469-269-4986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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