Provider Demographics
NPI:1851379895
Name:DYNAMIC IMAGING LLC
Entity Type:Organization
Organization Name:DYNAMIC IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:702-339-1560
Mailing Address - Street 1:205 N STEPHANIE ST
Mailing Address - Street 2:SUITE D #145
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8115
Mailing Address - Country:US
Mailing Address - Phone:702-339-1560
Mailing Address - Fax:702-436-9892
Practice Address - Street 1:1127 SIERRA LAUREL CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-8701
Practice Address - Country:US
Practice Address - Phone:702-339-1560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV246ZE0600X, 2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty
Not Answered2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty