Canton Specialty Imaging, LLC

NPI #1457640831 in Canton, Georgia

Provider Information

NPI Number: 1457640831
Entity Type: Organization
Organization Name: Canton Specialty Imaging, LLC
Primary Specialty: Specialist
Enumeration Date: Apr 6, 2011
Last Updated: Apr 6, 2011

Practice Location

Address: 200 OAKSIDE LN
Address 2: SUITE A
City: Canton
State: Georgia
ZIP Code: 30114-6416
Phone: (770) 479-1945

Authorized Official

Name: DR. BRADLEY R PETERS, M.D.
Title: MEMBER/MEDICAL DIRECTOR
Phone: (770) 479-1945

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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