Organization
SHORT PUMP IMAGING LLC
Active
Other names
Independence Park Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE R HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
9930 INDEPENDENCE PARK DR., STE 100, RICHMOND, VA 23233
(804) 217-9729
(804) 217-9584
Mailing address
9930 INDEPENDENCE PARK DR., STE 100, RICHMOND, VA 23233
(804) 217-9729
(804) 217-9584
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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