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Ambulatory Health Care Facilities Clinic/Center Radiology

Provider NPI: 1790875706

Organization Information:
Organization Name:  INDIANA MRI, LLC
Organization is not Subpart
Authorized Official:  OWEN  LAUER  MANAGING MEMBER  812-336-0056

Practice Location:
Tel: 812-331-7727  Fax: 812-331-8983

Business Mailing Address:
Tel: 812-336-0056  Fax: 812-336-0059

NPI Information:
NPI: 1790875706
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N261QR0200XAmbulatory Health Care Facilities
Y261QM1200XAmbulatory Health Care Facilities

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 261QM1200X





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