Organization
DIAGNOSTIC X-RAY SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB RUSSELL WUERSTLE (PRESIDENT)
(814) 459-6280
Entity
Organization
Contact information
Practice address
2828 MAIN ST, BUFFALO, NY 14214-1722
(814) 459-6280
Mailing address
1769 W 26TH ST, ERIE, PA 16508-1256
(800) 446-9729
(814) 459-6386
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01676219
—
NY
05
—
02997253
—
NY
Enumeration date
10/25/2006
Last updated
09/23/2024
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