Organization
LITTLE BEAR RADIOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRAIG LAGE MD (OWNER)
(573) 289-8211
Entity
Organization
Contact information
Practice address
1104 E BROADWAY, SUITE 205, COLUMBIA, MO 65201-5121
(417) 448-3713
Mailing address
1104 E BROADWAY, SUITE 205, COLUMBIA, MO 65201-5121
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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