Organization
PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC
Active
Other names
Dynamic Mobile Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ALLEN JOHNSON (VP-AO)
(303) 589-4149
Entity
Organization
Contact information
Practice address
1400 HAND AVE STE A, ORMOND BEACH, FL 32174-8195
(303) 500-1518
Mailing address
3825 N LAFAYETTE ST, DENVER, CO 80205-3316
(303) 500-1518
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
08/08/2023
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