# TRI-LAKES MOBILE ULTRASOUND INC.

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

## Provider details

- **NPI number:** 1669613451
- **Authorized official:** MRS. KATHLEEN ANN ROGERS RDMS,RVT,RDCS (OWNER/OPERATOR)
- **Authorized official phone:** (417) 350-8100

## Contact information

- **Practice address:** 5273 S AARON AVE, SPRINGFIELD, MO 65810-2879
- **Practice address phone:** (417) 350-8100
- **Practice address fax:** (417) 823-0464
- **Mailing address:** 5273 S AARON AVE, SPRINGFIELD, MO 65810-2879
- **Mailing address phone:** (417) 350-8100
- **Mailing address fax:** (417) 823-0464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 27998 | MO | Yes |

## Other

- **Enumeration date:** 03/09/2009
- **Last updated:** 04/28/2009