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Organization

LAKE WALES MEDICAL IMAGING CENTER ONE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KOLLAGUNTA CHANDRASEKHAR (PRESIDENT)
(863) 232-5111
Entity
Organization

Contact information

Practice address
1255 HIGHWAY 60 EAST 110, LAKE WALES, FL 33853
(863) 232-5111
Mailing address
2301 LONGLEAF BLVD SUITE 200, LAKE WALES, FL 33859

Taxonomy

Speciality
Code
Description
License number
State
247000000X
Health Information Technician
Primary

Other

Enumeration date
12/08/2008
Last updated
12/08/2008
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