| Organization Name: | PROFESSIONAL SONOGRAPHIC IMAGING |
| NPI Number: | 1194121764 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELISA DAWN TALWAR (MEDICAL SONOGRAPHER, RADIOGRAPHER) |
| Mailing Address: | 1505 Woodlawn Ave Suite B Dyersburg |
| State: | TN US |
| Postal Code: | 380243145 |
| Phone Number: | 7316767635 |
| Fax Number: | 7313345608 |
| NPI Enumeration Date: | 11/10/2014 |
| NPI Last Update Date: | 01/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0208X |
| License Number: | 17398 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology, Mobile |
| Taxonomy Definition: | |