Organization
MID-ATLANTIC MOBILE LITHOTRIPSY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA DAVIS (DIRECTOR, CBO)
(512) 314-4331
Entity
Organization
Contact information
Practice address
9825 SPECTRUM DR, BLDG 3, AUSTIN, TX 78717-4930
(888) 252-6575
Mailing address
PO BOX 847324, DALLAS, TX 75284-7324
Taxonomy
Speciality
Code
Description
License number
State
261QL0400X
Lithotripsy Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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