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Organization
SOURCE DIAGNOSTICS LLC
Active
Organization
SOURCE DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH C MARCHAND (PRESIDENT)
(440) 645-4626
Entity
Organization
Contact information
Practice address
5275 NAIMAN PKWY, STE E, SOLON, OH 44139-1029
(440) 542-1515
(440) 542-9482
Mailing address
5275 NAIMAN PKWY, STE E, SOLON, OH 44139-1029
(440) 645-7822
(440) 542-9482
Taxonomy
Speciality
Code
Description
License number
State
246W00000X
Cardiology Technician
—
NULL
246W00000X
Cardiology Technician
—
—
247100000X
Radiologic Technologist
Primary
OH03645
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2538052
—
OH
Enumeration date
05/22/2006
Last updated
03/08/2012
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