National Provider Identifier Database

TETON SPORTS SPINE IMAGING LLC
Magnetic Resonance Imaging (MRI)


Contact Information

TETON SPORTS & SPINE IMAGING, LLC
250 SCOTT LN STE 110
JACKSON, WY83001-8060
Phone: 307-201-5380
Fax: 307-201-5202
Website:
Specialty Taxonomy Code
* Magnetic Resonance Imaging (MRI) 261QM1200X
Radiology 261QR0200X

* Indicates primary specialty

NPI Profile & details for TETON SPORTS & SPINE IMAGING, LLC

NPI Number 1427574987
Legal business name
LBN
TETON SPORTS & SPINE IMAGING, LLC
Authorized official SHAUN ANDRIKOPOULOS - (MANAGER/PARTNER)
Entity Organization
Organization subpart No
Enumeration date 08/16/2017
Last updated 09/26/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • WY Medicaid: 1427574987

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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