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General NPI Number Information
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NPI Number | 1780655282
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Entity Type | Organization
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Legal Business Name | INDIANA OPEN MRI LLC
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1265 WAYNE AVE SUITE 305
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City | INDIANA
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State | PA
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Zip | 15701-3501
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Country | US
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Telephone | 724-349-3110
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Fax | 724-349-3149
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Provider Business Mailing Address
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Address Line | PO BOX 450
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City | NEW STANTON
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State | PA
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Zip | 15672-0450
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Country | US
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Telephone | 724-925-2330
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Fax | 724-925-7816
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Authorized Official
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Title or Position | TREASURER
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Name | MR. JACE D KELLER
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Credential |
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Telephone | 724-925-2280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | N/A
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License Number State |
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