Organization
PROFESSIONAL ULTRASOUND & IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTIAN HORTON LANE RTR, RCS (OWNER)
(910) 620-9097
Entity
Organization
Contact information
Practice address
136 MEMORY PLZ, WHITEVILLE, NC 28472-2640
(910) 914-6154
(910) 914-6156
Mailing address
PO BOX 434, CHADBOURN, NC 28431-0434
(910) 620-9097
(910) 623-1343
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
112625
NC
293D00000X
Physiological Laboratory
Primary
279513
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8105016
—
NC
Enumeration date
03/27/2007
Last updated
05/15/2015
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