| NPI | 1174502520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD J GRACE Director Of Institutional Relations 640-993-1640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center Radiology |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2020-08-22 |