Organization Name: | ULTRASOUND OF BELVIDERE LLC |
NPI Number: | 1376665224 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TINA SABITOSRA (OWNER) |
Mailing Address: | 1006 Logan Avenue Belvidere |
State: | IL US |
Postal Code: | 61008 |
Phone Number: | 8159883642 |
Fax Number: | 8155444775 |
NPI Enumeration Date: | 04/04/2007 |
NPI Last Update Date: | 05/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2471C3402X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | Radiography |
Taxonomy Definition: |