Organization
VALDOSTA IMAGING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS S GRAHAM (CEO)
(229) 242-8790
Entity
Organization
Contact information
Practice address
704 GIL HARBIN INDUSTRIAL BLVD, STE A, VALDOSTA, GA 31601-6513
(229) 242-8790
(229) 247-6868
Mailing address
PO BOX 400, LAKE PARK, GA 31636-0400
(229) 242-8790
(229) 247-6868
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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