Provider Demographics
NPI:1114276797
Name:SOUND IMAGING INC LLC
Entity Type:Organization
Organization Name:SOUND IMAGING INC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-785-0202
Mailing Address - Street 1:1614 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-6342
Mailing Address - Country:US
Mailing Address - Phone:573-785-0202
Mailing Address - Fax:573-785-1211
Practice Address - Street 1:1614 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-6342
Practice Address - Country:US
Practice Address - Phone:573-785-0202
Practice Address - Fax:573-785-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile