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General NPI Number Information
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NPI Number | 1982361424
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Entity Type | Organization
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Legal Business Name | LIFETOUCH IMAGING LLC
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 218 CALDWELL SUGAR RD
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-6698
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Country | US
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Telephone | 337-288-0736
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Fax |
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Provider Business Mailing Address
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Address Line | 218 CALDWELL SUGAR RD
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-6698
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Country | US
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Telephone | 337-288-0736
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Fax |
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Authorized Official
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Title or Position | OWNER/SONOGRAPHER
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Name | PEPPER MARIE BRASSEAUX
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Credential | RVT, RDMS-AB
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Telephone | 337-288-0736
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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