NPI 1619204203

Pioneer Medical Portable Xray,llc

Organisation Portable X-ray and/or Other Portable Diagnostic Imaging Supplier Petal, MS

Practice location

Address: 100 Clarendon Ave, Petal, MS 39465-2636
Phone: (601) 550-4611
Fax: (601) 510-9449

Authorised official

Name: Ted H Crabtree
Title: Owner
Phone: (601) 550-4611

Registered specialties

Portable X-ray and/or Other Portable Diagnostic Imaging Supplier Primary

Suppliers Taxonomy 335V00000X

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Registry record

NPI: 1619204203
Entity type: Organization
NPI issued: 3 Nov 2009
Record last updated: 10 Nov 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.