Provider Demographics
NPI:1255518619
Name:MOBILE SONOGRAPHERS INC
Entity type:Organization
Organization Name:MOBILE SONOGRAPHERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ENGELBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:605-940-1419
Mailing Address - Street 1:PO BOX 463
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57101-0463
Mailing Address - Country:US
Mailing Address - Phone:605-940-1419
Mailing Address - Fax:605-336-6558
Practice Address - Street 1:2307 E HARRIET LEA ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103
Practice Address - Country:US
Practice Address - Phone:605-940-1419
Practice Address - Fax:605-336-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD246XS1301X, 246XC2903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular SpecialistGroup - Multi-Specialty
No246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty