| NPI | 1114103504 |
|---|---|
| Doing Business As | PREVAHEALTH WELLNESS DIAGNOSTIC CENTER |
| Entity Type | Organization |
| Authorized Contact | GILLBERT GRADISAR President 614-652-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |