Organization
SPECIALT MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY GE R.T.(R)(MR)(ARRT) (MANAGING MEMBER)
(636) 333-1391
Entity
Organization
Contact information
Practice address
1823 SMIZER STATION RD, FENTON, MO 63026-2781
(636) 333-1391
(636) 333-1343
Mailing address
1823 SMIZER STATION RD, FENTON, MO 63026-2781
(636) 764-5194
(636) 333-1343
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
04/08/2024
Last updated
07/03/2026
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