Pioneer Medical Portable Xray,llc

NPI #1619204203 in Petal, Mississippi

Provider Information

NPI Number: 1619204203
Entity Type: Organization
Organization Name: Pioneer Medical Portable Xray,llc
Subpart: Yes (part of a larger organization)
Parent Organization: PIONEER MEDICAL, IDTF
Primary Specialty: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Enumeration Date: Nov 3, 2009
Last Updated: Nov 10, 2009

Practice Location

Address: 100 CLARENDON AVE
City: Petal
State: Mississippi
ZIP Code: 39465-2636
Phone: (601) 550-4611

Authorized Official

Name: TED H CRABTREE JR., RT
Title: OWNER
Phone: (601) 550-4611

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	335V00000X	Primary

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