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Physicians Radiology Body Imaging

Provider NPI: 1861484040

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 763-559-2171  Fax: 763-694-9000

Business Mailing Address:
2800 CAMPUS DR #10 PLYMOUTH, MN 55441-2645 US
Tel: 763-559-2171  Fax: 763-694-9000

NPI Information:
NPI: 1861484040
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Body Imaging

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2085R0202X





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