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Organization

MARYVILLE IMAGING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEITH A. PAGE FACH (PRESIDENT)
(618) 391-6406
Entity
Organization

Contact information

Practice address
2023 VADALABENE DR, SUITE 100, MARYVILLE, IL 62062-5630
(618) 288-4929
(618) 288-4531
Mailing address
6810 STATE ROUTE 162, BOX 215, MARYVILLE, IL 62062-8501
(618) 288-5711
(618) 288-4088

Taxonomy

Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary

Other

Enumeration date
06/27/2011
Last updated
06/08/2022
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