TETON SPORTS & SPINE IMAGING, LLC; NPI #1427574987

Contact Information

TETON SPORTS & SPINE IMAGING, LLC

250 SCOTT LN STE 110
JACKSON, WY 83001-8060

Phone: 307-201-5380
Fax: 307-201-5202
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Magnetic Resonance Imaging (MRI)	261QM1200X
Radiology	261QR0200X	74	Radiation Therapy Center

Indicates primary specialty

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

NPI Number 1427574987

LBN Legal business name TETON SPORTS & SPINE IMAGING, LLC

Authorized official SHAUN ANDRIKOPOULOS - (MANAGER/PARTNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/16/2017

Last updated 09/26/2024 - More than a year ago

Identifiers

Medicaid

1427574987

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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