# BOSTON OPEN MRI, LLC

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

## Provider details

- **NPI number:** 1902809064
- **Authorized official:** MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
- **Authorized official phone:** (502) 477-1815

## Contact information

- **Practice address:** 385 WESTERN AVE, BRIGHTON, MA 02135-1005
- **Practice address phone:** (617) 782-1690
- **Practice address fax:** (617) 782-1735
- **Mailing address:** 385 WESTERN AVE, BRIGHTON, MA 02135-1005
- **Mailing address phone:** (617) 782-1690
- **Mailing address fax:** (617) 782-1735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2471M1202X | Magnetic Resonance Imaging Radiologic Technologist | — | NULL | Yes |
| 2471M1202X | Magnetic Resonance Imaging Radiologic Technologist | — | — | Yes |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 08/22/2020