Organization
KING'S MEDICAL IMAGING AT WATERMARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. V. RENAE COYNE (DIRECTOR OF BILLING)
(330) 653-3968
Entity
Organization
Contact information
Practice address
1680 WATERMARK DR, STE 101, COLUMBUS, OH 43215-1034
(614) 485-1804
(614) 485-1321
Mailing address
1894 GEORGETOWN RD, HUDSON, OH 44236-4058
(330) 653-3968
(330) 656-1660
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2320698
—
OH
Enumeration date
05/23/2005
Last updated
08/22/2020
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