Organization
EAUCLAIRE OPEN MRI, LLC
Active
Other names
Chippewa Valley Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
(502) 477-1815
Entity
Organization
Contact information
Practice address
4130 STATE ROAD 93, EAU CLAIRE, WI 54701-7806
(715) 830-9507
(715) 830-9609
Mailing address
4130 STATE HWY 93, EAU CLAIRE, WI 54701-7806
(715) 830-9507
(715) 830-9609
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32880400
—
WI
Enumeration date
05/27/2005
Last updated
02/29/2008
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