Organization
INNOVATIVE TELERADIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER LYNN BOWES CRA (CEO)
(404) 803-8380
Entity
Organization
Contact information
Practice address
1176 MICHAEL LN, DECATUR, GA 30033-3900
(404) 803-8380
(404) 745-8744
Mailing address
1176 MICHAEL LN, DECATUR, GA 30033-3900
(404) 803-8380
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
Primary
—
—
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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