Organization
MOBILE SONOGRAPHY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL THOMAS (CEO)
(912) 704-1053
Entity
Organization
Contact information
Practice address
21 LAKE SHORE BLVD, PORT WENTWORTH, GA 31407-3612
(912) 704-1053
Mailing address
21 LAKE SHORE BLVD, PORT WENTWORTH, GA 31407-3612
(912) 704-1053
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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