Broad 64 Imaging Llc

NPI 1316015985 - Clinic/Center - 261QR0200X

NPI Details
NPI 1316015985
Enumeration Date 12/01/2006
Last Updated 03/02/2009
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name RICKY L RICKY
Position ADMINISTRATIVE DIRECTOR
Phone (804) 281-0215
Fax
Practice Location
6605 W BROAD ST
SUITE B - GROUND FLOOR
RICHMOND VA, 23230-1714, US
Phone (804) 281-0215
Fax
Business Location
7229 FOREST AVE
SUITE 208
RICHMOND VA, 23226-3765, US
Phone
Fax
Toxanomy
Taxonomy Code 261QR0200X
License State
License Number
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According to our database, Broad 64 Imaging Llc NPI is 1316015985, taxonomy code is 261QR0200X Broad 64 Imaging Llc physically located at 6605 W Broad St, Richmond VA, 23230-1714. NPI Number 1033115704 has the healthcare provider type.

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1316015985 NPI number is provided on an as is basis without warranty of any kind. 1316015985 is maintained by the National Plan & Provider Enumeration System. The contents of Broad 64 Imaging Llc are for informational purposes only.