Organization
PROFESSIONAL RADIOLOGY CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA J HANES (ADMINISTRATOR)
(814) 725-9800
Entity
Organization
Contact information
Practice address
612 W SMITH ST, CORRY, PA 16407-1152
(814) 664-4641
Mailing address
11487 SCOTLAND AVE, NORTH EAST, PA 16428-3143
(814) 725-9800
(814) 725-9800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD031177E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1916238
—
PA
01
—
PR1332073
BLUESHIELD
PA
Enumeration date
10/09/2006
Last updated
05/07/2008
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