Provider Demographics
NPI:1639328727
Name:SIOUX FALLS UPRIGHT MRI PROF LLC
Entity Type:Organization
Organization Name:SIOUX FALLS UPRIGHT MRI PROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-689-1010
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-0567
Mailing Address - Country:US
Mailing Address - Phone:605-689-1010
Mailing Address - Fax:605-689-1001
Practice Address - Street 1:6001 S SHARON AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5746
Practice Address - Country:US
Practice Address - Phone:605-689-1010
Practice Address - Fax:605-689-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty