MEDICARE: NATIONAL DIAGNOSTIC IMAGING CONSULTANTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0200X	Radiology Chiropractor

General Provider Information

NPI Number	:	1497055875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL DIAGNOSTIC IMAGING CONSULTANTS

Provider Business Mailing Address
First Line	:	PO BOX 80388
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-0388
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7834 PEACHMONT AVE NW
Second Line	:	APT. C6
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-8502
Country	:	US
Telephone Number	:	330-456-3601
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PHILLIP TASSI
Credential	:
Telephone Number	:	330-456-3601

Provider Enumeration Date	:	11/01/2010
Last Update Date	:	11/01/2010

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