Organization
APPOMATTOX IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE R HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
930 SOUTH AVE, SUITE 101, COLONIAL HEIGHTS, VA 23834-3621
(804) 524-2340
(804) 272-8752
Mailing address
930 SOUTH AVE, SUITE 101, COLONIAL HEIGHTS, VA 23834-3621
(804) 524-2340
(804) 272-8752
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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