Organization
ALLIED IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANAE DAVISON (AUTHORIZED OFFICIAL)
(208) 539-9923
Entity
Organization
Contact information
Practice address
2043 E CENTER ST STE 115, POCATELLO, ID 83201-3300
(208) 904-0498
Mailing address
2043 E CENTER ST STE 115, POCATELLO, ID 83201-3300
(208) 904-0498
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
154319
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699175158
—
ID
Enumeration date
09/02/2014
Last updated
11/02/2017
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