Provider Demographics
NPI:1194441444
Name:POETRY IN MOTION ULTRASOUND, LLC
Entity type:Organization
Organization Name:POETRY IN MOTION ULTRASOUND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RDMS, RVT
Authorized Official - Phone:575-266-9763
Mailing Address - Street 1:309 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3870
Mailing Address - Country:US
Mailing Address - Phone:575-236-2704
Mailing Address - Fax:575-408-8580
Practice Address - Street 1:121 S CANAL ST STE B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5735
Practice Address - Country:US
Practice Address - Phone:575-236-2704
Practice Address - Fax:575-408-8580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty