Provider Demographics
NPI:1598804635
Name:IMAGING DIAGNOSTICS IN MOTION LLC
Entity Type:Organization
Organization Name:IMAGING DIAGNOSTICS IN MOTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISTOL
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS RVS CCT
Authorized Official - Phone:603-437-9621
Mailing Address - Street 1:35 MANCHESTER RD
Mailing Address - Street 2:SUITE 11A, PMB 113
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-3064
Mailing Address - Country:US
Mailing Address - Phone:603-437-9621
Mailing Address - Fax:866-265-3113
Practice Address - Street 1:25 BARTLEY HILL RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-2427
Practice Address - Country:US
Practice Address - Phone:603-437-9621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center