Organization
CANTON SPECIALTY IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY R PETERS M.D. (MEMBER/MEDICAL DIRECTOR)
(770) 479-1945
Entity
Organization
Contact information
Practice address
200 OAKSIDE LN, SUITE A, CANTON, GA 30114-6416
(770) 479-1945
(770) 479-1948
Mailing address
200 OAKSIDE LN, SUITE A, CANTON, GA 30114-6416
(770) 479-1945
(770) 479-1948
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
051890
GA
Other
Enumeration date
04/06/2011
Last updated
04/06/2011
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