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Organization
OUTPATIENT DIAGNOSTIC IMAGING
Active
Organization
OUTPATIENT DIAGNOSTIC IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NEDRA ANNETTE CARRIER BSRT,R,M,RDMS,RVS (OWNER)
(337) 515-2674
Entity
Organization
Contact information
Practice address
3101 LAKE ST, LAKE CHARLES, LA 70601-8337
(337) 515-2674
(337) 616-8161
Mailing address
PO BOX 1943, LAKE CHARLES, LA 70602-1943
(337) 515-2674
(337) 616-8161
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
3780
LA
Other
Enumeration date
04/21/2008
Last updated
04/21/2008
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