Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Radiology, Mobile Mammography |
261QR0207X | 45 | Mammography Center | |
Diagnostic Radiology |
2085R0202X | 30 | Physician/Diagnostic Radiology |
| NPI Number | 1184278483 |
| LBN Legal business name | MAMMOLINK LLC |
| Authorized official | RYAN POLSELLI - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/25/2019 |
| Last updated | 09/26/2022 - About 4 years ago |
| Identifiers | n/a |
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