Organization
MEDICAL MILE IMAGING
Active
Parent organization
MEDICAL MILE IMAGING
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL MILE IMAGING
Authorized official
DR. DAN T SULLIVAN MD (PRESIDENT)
(417) 864-8360
Entity
Organization
Contact information
Practice address
3905 E WINDSMORE DR, SPRINGFIELD, MO 65802
(417) 864-8360
Mailing address
3905 E WINDSMORE, SPRINGFIELD, MO 65802
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R4804
MO
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
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