Organization
ROCKY MOUNTAIN MEDICAL IMAGING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM B WAHL MD (OWNER)
(303) 776-4824
Entity
Organization
Contact information
Practice address
1950 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3129
(303) 651-5111
Mailing address
PO BOX 1157, LONGMONT, CO 80502-1157
(970) 663-2742
(970) 667-0847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04195541
—
CO
05
—
10025345500
—
NE
01
—
CH6719
RAILROAD MEDICARE
—
Enumeration date
06/24/2006
Last updated
05/15/2012
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