Organization
IMAGING ADVANTAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASSAM CHABALLOUT (COO)
(310) 721-0200
Entity
Organization
Contact information
Practice address
425 W FIFTH ST, EAST LIVERPOOL, OH 43920-2405
(866) 708-6580
(314) 845-5667
Mailing address
6245 LEMAY FERRY RD, SAINT LOUIS, MO 63129-2805
(800) 354-1088
(314) 845-5668
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
04/02/2009
Last updated
04/02/2009
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