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General NPI Number Information
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NPI Number | 1932404811
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Entity Type | Organization
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Legal Business Name | HARMONIX DIAGNOSTICS LLC
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 15945 19 MILE RD STE. 103
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1147
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Country | US
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Telephone | 586-286-2350
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Fax | 586-286-8742
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Provider Business Mailing Address
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Address Line | 15945 19 MILE RD STE. 103
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1147
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Country | US
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Telephone | 586-286-2350
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Fax | 586-286-8742
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HOLLY WALLER
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Credential | RDCS
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Telephone | 586-286-2350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 128024
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License Number State | MI
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