Organization
BOSTON OPEN MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
(502) 477-1815
Entity
Organization
Contact information
Practice address
385 WESTERN AVE, BRIGHTON, MA 02135-1005
(617) 782-1690
(617) 782-1735
Mailing address
385 WESTERN AVE, BRIGHTON, MA 02135-1005
(617) 782-1690
(617) 782-1735
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1531760
—
MA
Enumeration date
05/23/2005
Last updated
08/22/2020
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