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General NPI Number Information
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NPI Number | 1922023175
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Entity Type | Organization
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Legal Business Name | SHILOH IMAGING CENTER LLC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1415 N WATTS ST
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City | SAYRE
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State | OK
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Zip | 73662-1310
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Country | US
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Telephone | 580-928-9980
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 N WATTS ST
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City | SAYRE
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State | OK
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Zip | 73662-1310
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Country | US
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Telephone | 580-928-9980
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ROBERT E MILLS
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Credential |
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Telephone | 580-928-9880
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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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