Organization
ADVANTAGE MOBILE DIAGNOSTIC IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES GILBERT MONTOYA RADIOGRAPHIC TECHNOL (OWNER)
(505) 280-1283
Entity
Organization
Contact information
Practice address
11212 CAMPO DEL SOL AVE NE, ALBUQUERQUE, NM 87123-1264
(505) 280-1283
Mailing address
11212 CAMPO DEL SOL AVE NE, ALBUQUERQUE, NM 87123-1264
(505) 280-1283
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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