Organization
MOBILE DIAGNOSTIC SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINDY MOORE (VICE PRESIDENT)
(309) 689-0243
Entity
Organization
Contact information
Practice address
1719 W WOODSIDE DR, DUNLAP, IL 61525-9572
(309) 689-0243
(309) 689-0205
Mailing address
1719 W WOODSIDE DR, DUNLAP, IL 61525-9572
(309) 689-0243
(309) 689-0205
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
335V00000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0259648
—
IA
Enumeration date
08/30/2006
Last updated
04/23/2012
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