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Organization
ADVANTAGE MOBILE DIAGNOSTIC IMAGING LLC
Active
Organization
ADVANTAGE MOBILE DIAGNOSTIC IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES GILBERT MONTOYA RADIOGRAPHIC TECHNOL (OWNER)
(505) 280-1283
Entity
Organization
Contact information
Practice address
11212 CAMPO DEL SOL AVE NE, ALBUQUERQUE, NM 87123-1264
(505) 280-1283
Mailing address
11212 CAMPO DEL SOL AVE NE, ALBUQUERQUE, NM 87123-1264
(505) 280-1283
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
NULL
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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