Organization
PROWAVE DIAGNOSTICS LLC
Active
Parent organization
IGH LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IGH LLC
Authorized official
STEPHANIE CONGER (BILLING MANAGER)
(615) 419-3375
Entity
Organization
Contact information
Practice address
238 PEACH LN, RIDGEDALE, MO 65739-4182
(831) 477-6633
Mailing address
PO BOX 130, RIDGEDALE, MO 65739-0130
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
MO
Other
Enumeration date
10/27/2012
Last updated
10/27/2012
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