# PROFESSIONAL PORTABLE RADIOLOGIC SERVICES INC

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

## Provider details

- **NPI number:** 1447061908
- **Authorized official:** BRUCE JOHNSON (VP/OGC)
- **Authorized official phone:** (303) 589-4149

## Contact information

- **Practice address:** 17527 NASSAU COMMONS BLVD STE 112, LEWES, DE 19958-6283
- **Practice address phone:** (866) 895-2120
- **Mailing address:** 3825 N LAFAYETTE ST, DENVER, CO 80205-3316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2025
- **Last updated:** 01/15/2025