Organization
IMH PROFESSIONAL RAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ED RUSH (PRESIDENT)
(704) 873-5661
Entity
Organization
Contact information
Practice address
557 BROOKDALE DR, STATESVILLE, NC 28677
(704) 873-5661
Mailing address
557 BROOKDALE DR, STATESVILLE, NC 28677
(704) 873-5661
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
01/25/2006
Last updated
08/22/2020
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