| NPI | 1114433604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN KERRY LAWRENCE Member 877-318-1349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0207X Clinic/Center, Radiology, Mobile Mammography |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2025-02-10 |