| NPI | 1154784205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD P. HOLLSTROM Authorized Official 706-594-0687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |