Organization
ULTRA IMAGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY JO C. CAMPBELL-WASHINGTON (OFFICE MANAGER)
(859) 254-3766
Entity
Organization
Contact information
Practice address
707 BURTON PIKE, GEORGETOWN, KY 40324
(859) 254-3766
(859) 299-3799
Mailing address
P O BOX 625, GEORGETOWN, KY 40324
(859) 254-3766
(859) 299-3799
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
720125
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86102019
—
KY
Enumeration date
02/21/2007
Last updated
04/17/2008
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