Organization
INDIAN WELLS ULTRASOUND IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES JACKSON WOODDELL RDMS (PRESIDENT)
(505) 443-0339
Entity
Organization
Contact information
Practice address
205 W BOUTZ RD. BLDG #1, LAS CRUCES, NM 88005
(505) 532-7000
(505) 532-7129
Mailing address
PO BOX 1744, ALAMOGORDO, NM 88311-1744
(505) 443-0339
(505) 434-5624
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
106930
NM
Other
Enumeration date
11/06/2006
Last updated
07/25/2007
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