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Physicians Radiology Body Imaging

Provider NPI: 1669815320

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
Tel: 952-993-1000  Fax: --

Business Mailing Address:
Tel: 651-592-3931  Fax: --

NPI Information:
NPI: 1669815320
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Body Imaging
Organized Health Care Education/Training Program

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2085R0202X





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