MEDICARE: SONOQUICK LLC

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	261QR0208X	Mobile Radiology Clinic/Center

General Provider Information

NPI Number	:	1982857959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SONOQUICK LLC

Provider Business Mailing Address
First Line	:	8107 GREEN FRST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78239-3209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8107 GREEN FRST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78239-3209
Country	:	US
Telephone Number	:	800-531-7801
Fax Number	:

Authorized Official
Title or Position	:	TECHNICAL DIRECTOR
Name	:	MR. JASON WALSH
Credential	:	RCS, RCIS, CCT
Telephone Number	:	800-551-7801

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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Directions to “SONOQUICK LLC ” Practice Location

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