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General NPI Number Information
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NPI Number | 1831123454
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Entity Type | Organization
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Legal Business Name | OPENSIDED MRI OF MILWAUKEE LLC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10919 W BLUEMOUND RD SUITE 200
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City | WAUWATOSA
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State | WI
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Zip | 53226
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Country | US
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Telephone | 888-606-6736
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Fax | 414-257-3967
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Provider Business Mailing Address
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Address Line | 10919 W BLUEMOUND RD SUITE 200
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City | WAUWATOSA
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State | WI
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Zip | 53226
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Country | US
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Telephone | 888-606-6736
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Fax | 414-257-3967
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Authorized Official
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Title or Position | OFFICER TREASURER
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Name | LINDA RHODES
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Credential |
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Telephone | 804-217-7114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number |
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License Number State |
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