| NPI | 1114285400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON G. FUNDERBURK Sole Owner 865-777-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-07-02 |