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Organization
PSI RADIOLOGICAL SERVICE, INC
Active
Organization
PSI RADIOLOGICAL SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR COLLADO M.D., PHD (RADIOLOGIST)
(313) 962-2133
Entity
Organization
Contact information
Practice address
1320 WILKINS ST, DETROIT, MI 48207-4802
(313) 656-2151
(313) 656-2152
Mailing address
547 E JEFFERSON AVE, DETROIT, MI 48226-4324
(313) 962-2133
(313) 962-2134
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
NULL
261QR0208X
Mobile Radiology Clinic/Center
—
NULL
293D00000X
Physiological Laboratory
—
NULL
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
24834
MI
Other
Enumeration date
03/08/2006
Last updated
05/04/2011
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