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General NPI Number Information
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NPI Number | 1952844896
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Entity Type | Organization
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Legal Business Name | PHYSICIANS FOR ULTRASOUND
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Dates
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Enumeration Date | 11/26/2016
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Last Update Date | 11/26/2016
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Provider Practice Location Address
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Address Line | 14904 JEFFERSON DAVIS HWY 206
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3908
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Country | US
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Telephone | 157-149-0515
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Fax |
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Provider Business Mailing Address
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Address Line | 14904 JEFFERSON DAVIS HWY 206
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3908
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Country | US
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Telephone | 157-149-0515
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE OFFICER
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Name | MR. MCCOY HAYES JR.
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Credential | RCS
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Telephone | 571-469-0515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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