| Organization Name: | DEL RIO IMAGING CENTER PA |
| NPI Number: | 1255454252 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL J CHARTRAND (CHAIRMAN) |
| Mailing Address: | 2209 Bedell Del Rio |
| State: | TN US |
| Postal Code: | 78840 |
| Phone Number: | 8307038543 |
| Fax Number: | 8307741430 |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471B0102X |
| License Number: | R27427 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Bone Densitometry |
| Taxonomy Definition: | |