Organization
DIAGNOSTIC IMAGING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS DEGENNARO (PRESIDENT)
(816) 853-8667
Entity
Organization
Contact information
Practice address
2020 N WOODLAWN ST, SUITE 350, WICHITA, KS 67208-1852
(316) 687-1674
(316) 687-5788
Mailing address
2020 N WOODLAWN ST, SUITE 350, WICHITA, KS 67208-1852
(316) 687-1674
(316) 687-5788
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100409770A
—
KS
Enumeration date
01/12/2007
Last updated
08/01/2014
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