Organization
HOCKING VALLEY IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY BONTRAGER M.D. (PRESIDENT)
(740) 380-6665
Entity
Organization
Contact information
Practice address
31500 CHIEFTAIN DR, STE B, LOGAN, OH 43138-8421
(740) 380-6665
(740) 380-6635
Mailing address
31500 CHIEFTAIN DR, STE B, LOGAN, OH 43138-8421
(740) 380-6665
(740) 380-6635
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
1071IC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2435261
—
OH
Enumeration date
07/18/2005
Last updated
08/22/2020
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