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General NPI Number Information
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NPI Number | 1871027219
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Entity Type | Organization
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Legal Business Name | SCAN CLEAR LLC
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 43650 GARFIELD RD STE 102
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-7419
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Country | US
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Telephone | 248-243-4674
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Fax | 586-221-4616
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Provider Business Mailing Address
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Address Line | PO BOX 70286
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-0006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOSEPH RUEFIEL
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Credential |
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Telephone | 248-243-4674
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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 |
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License Number State |
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