Provider Demographics
NPI:1467638445
Name:SOUNDWAVE IMAGING, INC.
Entity Type:Organization
Organization Name:SOUNDWAVE IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RVT
Authorized Official - Phone:314-276-7028
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:MILLSTADT
Mailing Address - State:IL
Mailing Address - Zip Code:62260-0308
Mailing Address - Country:US
Mailing Address - Phone:314-276-7028
Mailing Address - Fax:
Practice Address - Street 1:522 N NEW BALLAS RD STE 270
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6819
Practice Address - Country:US
Practice Address - Phone:314-276-7028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology