| NPI | 1023439767 |
|---|---|
| Doing Business As | DBA ENVISION IMAGING AT SOUTH LAKE |
| Entity Type | Organization |
| Authorized Contact | ANDREW BENSON Chief Revenue Officer 719-955-4332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| 261QR0200X Clinic/Center, Radiology | |
| Enumeration Date | 2013-12-24 |
| Last Update Date | 2024-03-26 |