Organization
MANASSEH MEDICAL IMAGING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY ROSALES RT(ARRT) (PRESIDENT)
(806) 239-0509
Entity
Organization
Contact information
Practice address
4311 IRONTON AVE, #2, LUBBOCK, TX 79407-3735
(806) 239-0509
Mailing address
PO BOX 16856, LUBBOCK, TX 79490-6856
(806) 771-1386
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
FTUVC9
TX
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
12/03/2007
Last updated
04/25/2023
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