| NPI | 1003490517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BRADFORD CFO/AO 270-762-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2022-04-18 |