Lake Wales Medical Imaging Center One, INC
NPI #1063657955 in Lake Wales, Florida
Provider Information
- NPI Number
- 1063657955
- Entity Type
- Organization
- Organization Name
- Lake Wales Medical Imaging Center One, INC
- Primary Specialty
- Technician, Health Information
- Enumeration Date
- Dec 8, 2008
- Last Updated
- Dec 8, 2008
Practice Location
- Address
- 1255 HIGHWAY 60 EAST 110
- City
- Lake Wales
- State
- Florida
- ZIP Code
- 33853
- Phone
- (863) 232-5111
Authorized Official
- Name
- DR. KOLLAGUNTA CHANDRASEKHAR
- Title
- PRESIDENT
- Phone
- (863) 232-5111
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician, Health Information |
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