Basic Information
| Provider Information | |||||||||
| NPI: | 1497993943 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | RANEY | ||||||||
| FirstName: | LAURENCE | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | RPARRART,R,CT,QM,BD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2121 NORTH AVE | ||||||||
| Address2: | RADIOLOGY-114 | ||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815016428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702420731 | ||||||||
| FaxNumber: | 9702568907 | ||||||||
| Practice Location | |||||||||
| Address1: | 2121 NORTH AVE | ||||||||
| Address2: | RADIOLOGY-114 | ||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815016428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702420731 | ||||||||
| FaxNumber: | 9702568907 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2009 | ||||||||
| LastUpdateDate: | 08/09/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 243U00000X | 04CO1111 | CO | Y | Technologists, Technicians & Other Technical Service Providers | Radiology Practitioner Assistant | 2471C3401X | 194525 | CO | N | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Computed Tomography | 2471C3402X | 194525 | CO | N | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Radiography | 2471Q0001X | 194525 | CO | N | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Quality Management | 2471B0102X | 194525 | CO | N | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Bone Densitometry |
No ID Information.