# SOUTHTOWNE IMAGING CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104991918
- **Authorized official:** HENRY BOOTS (OWNER/MANAGER)
- **Authorized official phone:** (573) 315-9109

## Contact information

- **Practice address:** 20 SOUTHTOWNE DR, POTOSI, MO 63664-5729
- **Practice address phone:** (573) 436-6736
- **Practice address fax:** (573) 436-7321
- **Mailing address:** 20 SOUTHTOWNE DR, POTOSI, MO 63664-5729
- **Mailing address phone:** (573) 436-6736
- **Mailing address fax:** (573) 436-7321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 02/17/2015