Organization
VALLEY DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MONTI L KIST (PRESIDENT/OWNER)
(479) 967-6492
Entity
Organization
Contact information
Practice address
2504 W MAIN ST, SUITE H, RUSSELLVILLE, AR 72801-2533
(479) 967-6492
(479) 967-6509
Mailing address
PO BOX 9010, RUSSELLVILLE, AR 72811-9010
(479) 967-6492
(479) 967-6509
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146594002
—
AR
Enumeration date
10/03/2006
Last updated
10/18/2007
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