Provider Application

Magnetic Imaging Services, Inc. is always looking to expand its coverage with the highest quality professional providers and imaging facilities. If you are a quality medical imaging provider and would like to know more about becoming a part of the MIS team, contact us, either via the form below, or by phone, fax or email and we will discuss in detail the  requirements MIS has for its providers.

For further information on what it takes to become part of the MIS family, call 800 894-4MRI (800-894-4674) or fill out the form below.

Facility Name 
Address of the Facility 
City, State Zip  
Contact Name 
Email 
Phone Number 
Fax Number