| Incontrol Imaging Moore LLC | |
|
1112 Sw 30th Ct Ste 101 Moore OK 73160-2888 | |
| (405) 645-7718 | |
| Not Available |
| Full Name | Incontrol Imaging Moore LLC |
|---|---|
| Speciality | Clinic/center - Radiology |
| Location | 1112 Sw 30th Ct Ste 101, Moore, Oklahoma |
| Authorized Official Name and Position | Lisa Burris (PRESIDENT / OWNER) |
| Authorized Official Contact | 3177960157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Incontrol Imaging Moore LLC 1112 Sw 30th Ct Ste 101 Moore OK 73160-2888 Ph: (405) 645-7718 | Incontrol Imaging Moore LLC 1112 Sw 30th Ct Ste 101 Moore OK 73160-2888 Ph: (405) 645-7718 |
| NPI Number | 1861383655 |
|---|---|
| Provider Enumeration Date | 07/10/2025 |
| Last Update Date | 07/14/2025 |
| Certification Date | 07/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861383655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Secondary |
| 261QR0200X | Clinic/center - Radiology | () | Primary |
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