Organization
MIDWAY ULTRASOUND DIAGNOSTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD FRANCIS CROOKS RDMS, RVT, RDCS (OWNET)
(678) 994-5407
Entity
Organization
Contact information
Practice address
1801 SE HILLMOOR DR, PORT ST LUCIE, FL 34952-7553
(678) 994-5407
Mailing address
1801 SE HILLMOOR DR, PORT ST LUCIE, FL 34952-7553
(678) 994-5407
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
42861
MD
Other
Enumeration date
07/31/2016
Last updated
07/31/2016
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