# PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dynamic Mobile Imaging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790489326
- **Authorized official:** BRUCE ALLEN JOHNSON (VP-AO)
- **Authorized official phone:** (303) 589-4149

## Contact information

- **Practice address:** 1400 HAND AVE STE A, ORMOND BEACH, FL 32174-8195
- **Practice address phone:** (303) 500-1518
- **Mailing address:** 3825 N LAFAYETTE ST, DENVER, CO 80205-3316
- **Mailing address phone:** (303) 500-1518

## Taxonomy

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

## Other

- **Enumeration date:** 03/28/2023
- **Last updated:** 08/08/2023