| NPI | 1053922849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE M MILES Owner 219-617-8218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| 251E00000X Home Health | |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2022-11-03 |