Organization
MANTRO MOBILE IMAGING LLC
Active
Parent organization
MANTRO MOBILE IMAGING
Organization subpart
Yes
Provider details
NPI number
Legal business name
MANTRO MOBILE IMAGING
Authorized official
MR. KENNETH ROGER CHAPMAN JR. RN (MANAGING MEMBER)
(702) 896-0473
Entity
Organization
Contact information
Practice address
8778 S MARYLAND PKWY, SUITE 105, LAS VEGAS, NV 89123-6704
(702) 896-0473
(702) 586-0528
Mailing address
8778 S MARYLAND PKWY, SUITE 105, LAS VEGAS, NV 89123-6704
(702) 896-0473
(702) 586-0528
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285789370
NPI
—
05
—
29X0009810
—
NV
01
—
V103481
MEDICARE PTAN
—
Enumeration date
10/12/2011
Last updated
01/30/2016
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