# PSI RADIOLOGICAL SERVICE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821066648
- **Authorized official:** DR. VICTOR COLLADO M.D., PHD (RADIOLOGIST)
- **Authorized official phone:** (313) 962-2133

## Contact information

- **Practice address:** 1320 WILKINS ST, DETROIT, MI 48207-4802
- **Practice address phone:** (313) 656-2151
- **Practice address fax:** (313) 656-2152
- **Mailing address:** 547 E JEFFERSON AVE, DETROIT, MI 48226-4324
- **Mailing address phone:** (313) 962-2133
- **Mailing address fax:** (313) 962-2134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | 24834 | MI | Yes |

## Other

- **Enumeration date:** 03/08/2006
- **Last updated:** 05/04/2011