| NPI | 1124394895 |
|---|---|
| Doing Business As | SOURCE DIAGNOSTICS OF INDIANA |
| Entity Type | Organization |
| Authorized Contact | KATHLEEN A BARRY COO 440-645-7822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2013-03-06 |