Provision Imaging of Lake County
NPI #1831113927 in Painesville, Ohio
Provider Information
- NPI Number
- 1831113927
- Entity Type
- Organization
- Organization Name
- Provision Imaging of Lake County
- Primary Specialty
- Clinic/Center - Radiology
- Enumeration Date
- Jul 26, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 7511 FREDLE DR
- City
- Painesville
- State
- Ohio
- ZIP Code
- 44077-9406
- Phone
- (440) 354-3686
Authorized Official
- Name
- ROBERT MATT TRENT
- Title
- COO
- Phone
- (405) 842-7768
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Radiology — Radiology |
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