| Organization Name: | IMPACT IMAGING, INC. |
| NPI Number: | 1154431625 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK ALAN MARSEE (OPERATIONS MANAGER) |
| Mailing Address: | 207 Bryant Pl Del City |
| State: | OK US |
| Postal Code: | 731151001 |
| Phone Number: | 4056776121 |
| Fax Number: | 4055733263 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0208X |
| License Number: | OK2749701 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology, Mobile |
| Taxonomy Definition: | |