| NPI | 1033235619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WELLHAUSEN Administrator 901-726-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2471R0002X Radiologic Technologist Radiation Therapy |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: TN 0000000074) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2021-11-22 |