Provider Demographics
NPI:1629612825
Name:INJURY IMAGING SOLUTIONS LLC
Entity Type:Organization
Organization Name:INJURY IMAGING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-706-6810
Mailing Address - Street 1:173 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04861-3807
Mailing Address - Country:US
Mailing Address - Phone:207-706-6810
Mailing Address - Fax:
Practice Address - Street 1:3139 E LINCOLN DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2317
Practice Address - Country:US
Practice Address - Phone:602-368-2758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)