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Organization
LIFESCAN IMAGING, LLC
Active
Organization
LIFESCAN IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
(502) 403-1401
Entity
Organization
Contact information
Practice address
607 CLIFTY ST, STE 102, SOMERSET, KY 42503-1765
(606) 677-6664
(606) 677-6560
Mailing address
607 CLIFTY ST, STE 102, SOMERSET, KY 42503-1765
(606) 677-6664
(606) 677-6560
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
NULL
261QR0200X
Radiology Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/23/2005
Last updated
01/27/2010
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