Provider Demographics
NPI:1063618320
Name:ADVANCED MOTION X-RAY
Entity type:Organization
Organization Name:ADVANCED MOTION X-RAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-559-6552
Mailing Address - Street 1:PO BOX 14434
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-7434
Mailing Address - Country:US
Mailing Address - Phone:330-559-6552
Mailing Address - Fax:330-729-9166
Practice Address - Street 1:1315 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE 2
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4075
Practice Address - Country:US
Practice Address - Phone:330-559-6552
Practice Address - Fax:330-729-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier