Organization
DR MOBILE IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIN RAY MODISETTE (OWNER)
(318) 475-0690
Entity
Organization
Contact information
Practice address
23 WESTHAVEN PL, JACKSON, TN 38305-1758
(731) 803-1078
(731) 435-3385
Mailing address
23 WESTHAVEN PL, JACKSON, TN 38305-1758
(731) 803-1078
(731) 435-3385
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
12/28/2022
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