Organization
GALAX RADIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W BOLEN JR. MD (PRESIDENT)
(276) 236-8175
Entity
Organization
Contact information
Practice address
110 VALLEY ST, GALAX, VA 24333-2224
(703) 236-8175
Mailing address
110 VALLEY ST, GALAX, VA 24333-2224
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5920855
—
NC
01
—
C15351
RR MEDICARE
—
Enumeration date
02/06/2006
Last updated
02/11/2014
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