# MODIMOON ENTERPRISES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Watson Imaging Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811906944
- **Authorized official:** MS. JENNIFER MOON (PRESIDENT)
- **Authorized official phone:** (314) 781-9711

## Contact information

- **Practice address:** 3915 WATSON RD, STE. LL2, SAINT LOUIS, MO 63109-1251
- **Practice address phone:** (314) 781-9711
- **Mailing address:** 3915 WATSON RD, STE. LL2, SAINT LOUIS, MO 63109-1251
- **Mailing address phone:** (314) 781-9711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | NA | MO | Yes |
| 261QR0206X | Mammography Clinic/Center | NA | MO | — |

## Other

- **Enumeration date:** 08/07/2006
- **Last updated:** 06/25/2008