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Organization
INDIAN WELLS ULTRASOUND IMAGING INC
Active
Organization
INDIAN WELLS ULTRASOUND IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES JACKSON WOODDELL RDMS (PRESIDENT)
(505) 443-0339
Entity
Organization
Contact information
Practice address
205 W BOUTZ RD. BLDG #1, LAS CRUCES, NM 88005
(505) 532-7000
(505) 532-7129
Mailing address
PO BOX 1744, ALAMOGORDO, NM 88311-1744
(505) 443-0339
(505) 434-5624
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
106930
NM
Other
Enumeration date
11/06/2006
Last updated
07/25/2007
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