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General NPI Number Information
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NPI Number | 1891737490
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Entity Type | Organization
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Legal Business Name | EAST COBB MRI CENTER
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1197 JOHNSON FERRY RD SUITE 200
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City | MARIETTA
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State | GA
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Zip | 30068-2718
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Country | US
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Telephone | 770-971-7284
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Fax | 770-619-2760
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Provider Business Mailing Address
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Address Line | 4205 N POINT PKWY BUILDING D
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City | ALPHARETTA
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State | GA
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Zip | 30022-8808
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Country | US
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Telephone | 770-619-2767
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Fax | 770-619-2760
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LAURA M ROSING
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Credential |
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Telephone | 770-619-2767
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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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