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Organization
MODIMOON ENTERPRISES, LLC
Active
Organization
MODIMOON ENTERPRISES, LLC
Active
Other names
Watson Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER MOON (PRESIDENT)
(314) 781-9711
Entity
Organization
Contact information
Practice address
3915 WATSON RD, STE. LL2, SAINT LOUIS, MO 63109-1251
(314) 781-9711
Mailing address
3915 WATSON RD, STE. LL2, SAINT LOUIS, MO 63109-1251
(314) 781-9711
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
NA
MO
261QR0206X
Mammography Clinic/Center
NA
MO
Other
Enumeration date
08/07/2006
Last updated
06/25/2008
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