Organization
CODY IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS GRAHAM M.D. (MEDICAL DIRECTOR)
(307) 586-2958
Entity
Organization
Contact information
Practice address
720 LINDSAY LN STE D, CODY, WY 82414-4143
(307) 586-2958
(307) 586-4158
Mailing address
3206 4TH ST, LONGVIEW, TX 75605-5143
(903) 663-4800
(903) 663-7394
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2021
Last updated
11/15/2021
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