Organization
FS OUTPATIENT IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J KELLEY (SOLE MEMBER)
(262) 577-8765
Entity
Organization
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(262) 656-2950
Mailing address
6308 8TH AVE, KENOSHA, WI 53143-5031
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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