# LACKAWANNA X-RAY, LLC

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

## Provider details

- **NPI number:** 1457652687
- **Authorized official:** MR. PAUL C WOELKERS R.T. (PRESIDENT)
- **Authorized official phone:** (570) 346-8809

## Contact information

- **Practice address:** 1229 MONROE AVE, DUNMORE, PA 18509-2807
- **Practice address phone:** (570) 346-8809
- **Practice address fax:** (570) 346-5121
- **Mailing address:** 1229 MONROE AVE, DUNMORE, PA 18509-2807
- **Mailing address phone:** (570) 346-8809
- **Mailing address fax:** (570) 346-5121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 11/04/2010
- **Last updated:** 11/04/2010