Organization
PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC.
Active
Other names
Professional Portable X-ray, Inc., PPX
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ALLEN JOHNSON (VP-AO)
(303) 589-4149
Entity
Organization
Contact information
Practice address
27065 SUNRISE AVE., UNIT A1, SIOUX FALLS, SD 57106-5915
(866) 895-2119
(952) 890-9025
Mailing address
755 CLIFF RD E, BURNSVILLE, MN 55337-1545
(866) 895-2119
(952) 890-9025
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
630000003
MEDICAREPIN
MN
Enumeration date
04/27/2011
Last updated
03/31/2025
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