Provider Demographics
NPI:1972331288
Name:MT IMAGING CENTERS LLC
Entity type:Organization
Organization Name:MT IMAGING CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TATE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KREITINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-890-9552
Mailing Address - Street 1:189 LAKESIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:MT
Mailing Address - Zip Code:59922-9723
Mailing Address - Country:US
Mailing Address - Phone:406-890-9552
Mailing Address - Fax:
Practice Address - Street 1:3201 US HIGHWAY 93 N
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-6848
Practice Address - Country:US
Practice Address - Phone:406-890-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty