Provider Demographics
NPI:1730619289
Name:INJURY IMAGING SOLUTIONS LLC
Entity type:Organization
Organization Name:INJURY IMAGING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-706-6810
Mailing Address - Street 1:173 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04861-3807
Mailing Address - Country:US
Mailing Address - Phone:207-354-5089
Mailing Address - Fax:877-422-0832
Practice Address - Street 1:1345 E MCKELLIPS RD STE 103
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2721
Practice Address - Country:US
Practice Address - Phone:480-644-9878
Practice Address - Fax:480-644-9879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)