Organization
WACCAMAW IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY GRIGSBY (MANAGER)
(910) 646-1452
Entity
Organization
Contact information
Practice address
3806 PEACHTREE AVE, WILMINGTON, NC 28403-6751
(910) 646-1452
Mailing address
112 E WHITE OAK ST, LAKE WACCAMAW, NC 28450-2128
(910) 646-1452
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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