| NPI | 1164009981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA JILL HONNOLL Owner / Member 662-588-8616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2022-03-09 |