PROVENA IMAGING SERVICES INC

BOURBONNAIS, IL
NPI1720197601
Entity TypeOrganization
Authorized ContactEDWARD MOLARE
President
815-806-2309
Organization Subpart ?No
Primary Taxonomy2085R0202X Radiology Diagnostic Radiology
Enumeration Date2006-08-30
Last Update Date2020-08-22
Business Address
PROVENA IMAGING SERVICES INC
100 PROVENA WAY SUITE 104
BOURBONNAIS, IL 60914
Phone number: 815-929-5800
Mailing Address
PROVENA IMAGING SERVICES INC
5775 WAYZATA BLVD SUITE 400
ST LOUIS PARK, MN 55416
Phone number: 952-542-8553
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