| NPI | 1043228471 |
|---|---|
| Other Name | RADIOLOGIST |
| Entity Type | Organization |
| Authorized Contact | KATHLEEN ANN DEPONTE President 276-679-2729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 35177) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 28258) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 35510) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 25573) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2015-07-13 |