Executive Image INC
NPI #1588759849 in Winston Salem, North Carolina
Provider Information
- NPI Number
- 1588759849
- Entity Type
- Organization
- Organization Name
- Executive Image INC
- Primary Specialty
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Enumeration Date
- Oct 4, 2006
- Last Updated
- Jan 15, 2015
Practice Location
- Address
- 7820 N POINT BLVD
- Address 2
- SUITE 101
- City
- Winston Salem
- State
- North Carolina
- ZIP Code
- 27106-3299
- Phone
- (336) 245-0647
Authorized Official
- Name
- MS. DIANA GOOLSBY
- Title
- OWNER
- Phone
- (336) 918-6328
Specialties & Taxonomy Codes
| Specialty |
|---|
| Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
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