Provider Demographics
NPI:1487982575
Name:SPEECH IMAGING LLC
Entity type:Organization
Organization Name:SPEECH IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-463-0778
Mailing Address - Street 1:9075 HUNTINGTON OAK DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-2345
Mailing Address - Country:US
Mailing Address - Phone:901-463-0778
Mailing Address - Fax:
Practice Address - Street 1:9075 HUNTINGTON OAK DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-2345
Practice Address - Country:US
Practice Address - Phone:901-463-0778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech