Organization
KODIAK DIAGNOSTIC IMAGING, PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS E RIO MD (PRESIDENT)
(907) 486-2466
Entity
Organization
Contact information
Practice address
1915 E REZANOF DR, KODIAK, AK 99615-6602
(907) 539-8997
Mailing address
384 LILLY DR, KODIAK, AK 99615-7115
(907) 486-2466
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4924
AK
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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