Provider Demographics
NPI:1336437060
Name:SONO-ASSIST IMAGING SERVICES, LLC
Entity type:Organization
Organization Name:SONO-ASSIST IMAGING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LADELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:704-728-7011
Mailing Address - Street 1:4801 E INDEPENDENCE BLVD
Mailing Address - Street 2:STE. # 502
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-5400
Mailing Address - Country:US
Mailing Address - Phone:704-728-7011
Mailing Address - Fax:704-391-9746
Practice Address - Street 1:4801 E INDEPENDENCE BLVD
Practice Address - Street 2:STE. # 502
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-5400
Practice Address - Country:US
Practice Address - Phone:704-728-7011
Practice Address - Fax:704-391-9746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1225932471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty