# CHAMPLAIN VALLEY OPEN MRI LLC

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

## Provider details

- **NPI number:** 1215986575
- **Authorized official:** MICHELLE DOUGLAS (CONTRACT MANAGER)
- **Authorized official phone:** (502) 403-1401

## Contact information

- **Practice address:** 118 CONSUMER SQ, PLATTSBURGH, NY 12901-6507
- **Practice address phone:** (518) 562-3650
- **Practice address fax:** (518) 562-3801
- **Mailing address:** 118 CONSUMER SQ, PLATTSBURGH, NY 12901-6507
- **Mailing address phone:** (518) 562-3650
- **Mailing address fax:** (518) 562-3801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/06/2006
- **Last updated:** 12/05/2008