Organization
TWIN PEAKS MEDICAL IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM B WAHL MD (PRESIDENT)
(877) 662-4041
Entity
Organization
Contact information
Practice address
1950 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3129
(720) 494-4777
Mailing address
PO BOX 87, LONGMONT, CO 80502-0087
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39785211
—
CO
01
—
662372
BCBS
CO
01
—
P00083975
RAILROAD MEDICARE
CO
Enumeration date
06/24/2006
Last updated
10/04/2007
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