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General NPI Number Information
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NPI Number | 1922079516
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Entity Type | Organization
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Legal Business Name | IMAGING CENTERS OF OHIO, LLC
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 PARK CENTER DR
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City | WADSWORTH
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State | OH
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Zip | 44281-7100
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Country | US
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Telephone | 440-897-6556
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PARK CENTER DR
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City | WADSWORTH
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State | OH
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Zip | 44281-8719
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Country | US
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Telephone | 440-897-6556
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARRIS FREED
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Credential | M.D.
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Telephone | 440-897-6556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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