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Organization

CRYSTAL CLEAR IMAGING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBIN E OSBORN D.O. (PRESIDENT)
(937) 398-0500
Entity
Organization

Contact information

Practice address
2100 EMMANUEL WAY, SPRINGFIELD, OH 45502-7217
(937) 398-0500
(937) 398-0370
Mailing address
PO BOX 951015, CLEVELAND, OH 44193-0005
(866) 917-3597

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000232727
ANTHEM
OH
05
2364249
OH
Enumeration date
01/20/2006
Last updated
04/08/2008
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