Organization
ADVANCED IMAGING SPECIALTIES LLC
Active
Other names
Advanced Imaging Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER T MALLAVARAPU M.D. (MANAGER)
(337) 261-0928
Entity
Organization
Contact information
Practice address
120 W MAIN ST, SUITE 2, VILLE PLATTE, LA 70586-4574
(337) 363-5684
Mailing address
5000 AMBASSADOR CAFFERY PKWY, BUILDING 1, LAFAYETTE, LA 70508-6984
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/05/2009
Last updated
11/01/2010
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