Organization
PDI TOLEDO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK CHAMPNEY CORNELL (AUTHORIZED OFFICIAL)
(440) 223-8848
Entity
Organization
Contact information
Practice address
3830 WOODLEY RD, SUITE A, TOLEDO, OH 43606-1176
(419) 517-0500
(419) 517-0501
Mailing address
3830 WOODLEY RD, SUITE A, TOLEDO, OH 43606-1176
(419) 517-0500
(419) 517-0501
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
1248IC
OH
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2678651
—
OH
Enumeration date
05/10/2006
Last updated
10/09/2023
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