Organization
RADIOLOGY SPECIALTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN J LEWIS RT (OWNER)
(404) 784-8792
Entity
Organization
Contact information
Practice address
5434 EMILY CIR, ELLENWOOD, GA 30294-4326
(404) 784-8792
Mailing address
PO BOX 887, REX, GA 30273-0887
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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