Innovative Medical Imaging, Pllc
NPI #1962015776 in Twin Falls, Idaho
Provider Information
- NPI Number
- 1962015776
- Entity Type
- Organization
- Organization Name
- Innovative Medical Imaging, Pllc
- Primary Specialty
- Radiology - Diagnostic Radiology
- Enumeration Date
- Aug 31, 2020
- Last Updated
- Feb 12, 2024
Practice Location
- Address
- 512 POLE LINE RD STE 1
- City
- Twin Falls
- State
- Idaho
- ZIP Code
- 83301-6367
- Phone
- (208) 735-5555
Authorized Official
- Name
- STEPHAN G THIEDE, MD
- Title
- AUTHORIZED OFFICIAL
- Phone
- (541) 334-7550
Specialties & Taxonomy Codes
| Specialty |
|---|
| Radiology - Diagnostic Radiology — Diagnostic Radiology |
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