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Organization
PROWAVE DIAGNOSTICS LLC
Active
Organization
PROWAVE DIAGNOSTICS LLC
Active
Parent organization
IGH LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IGH LLC
Authorized official
STEPHANIE CONGER (BILLING MANAGER)
(615) 419-3375
Entity
Organization
Contact information
Practice address
238 PEACH LN, RIDGEDALE, MO 65739-4182
(831) 477-6633
Mailing address
PO BOX 130, RIDGEDALE, MO 65739-0130
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
MO
Other
Enumeration date
10/27/2012
Last updated
10/27/2012
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