Organization
CHILDERSBURG DIAGNOSTIC IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T BICE (ADMINISTRATOR)
(256) 378-3313
Entity
Organization
Contact information
Practice address
34011 US HIGHWAY 280, CHILDERSBURG, AL 35044-2128
(256) 378-3313
Mailing address
PO BOX 349, CHILDERSBURG, AL 35044-0349
(256) 378-3313
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
11948
AL
Other
Enumeration date
02/08/2008
Last updated
02/15/2008
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