| Organization Name: | CRESTVIEW OPEN MRI INC |
| NPI Number: | 1073569166 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUE CADENHEAD (PRESIDENT) |
| Mailing Address: | 194 E Redstone Ave Ste. A Crestview |
| State: | FL US |
| Postal Code: | 325395348 |
| Phone Number: | 8506896705 |
| Fax Number: | |
| NPI Enumeration Date: | 05/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | 000439 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |