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General NPI Number Information
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NPI Number | 1770946170
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Entity Type | Organization
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Legal Business Name | THE ECHO GUY LLC
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 4648 TATERSALL CT
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City | GAHANNA
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State | OH
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Zip | 43230-8323
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Country | US
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Telephone | 614-256-2564
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Fax |
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Provider Business Mailing Address
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Address Line | 4648 TATERSALL CT
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City | GAHANNA
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State | OH
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Zip | 43230-8323
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Country | US
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Telephone | 614-256-2564
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Fax |
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Authorized Official
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Title or Position | PARTNER / OWNER
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Name | MR. ILIJA JANEVSKI
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Credential | RDCS, RVT
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Telephone | 614-256-2564
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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 | 125193
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License Number State | OH
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