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General NPI Number Information
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NPI Number | 1821141102
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Entity Type | Organization
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Legal Business Name | MANSFIELD IMAGING CENTER LLC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 536 S TRIMBLE RD SUITE A
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City | MANSFIELD
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State | OH
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Zip | 44906-3418
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Country | US
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Telephone | 419-774-9729
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Fax | 419-774-0006
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Provider Business Mailing Address
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Address Line | 536 S TRIMBLE RD SUITE A
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City | MANSFIELD
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State | OH
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Zip | 44906-3418
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Country | US
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Telephone | 419-774-9729
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Fax | 419-774-0006
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. JOHN COX
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Credential |
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Telephone | 419-522-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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