| NPI | 1174674691 |
|---|---|
| Doing Business As | PINE LAKE IMRT |
| Entity Type | Organization |
| Authorized Contact | BENNETT BARRIOS Managing Member 402-327-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0203X Clinic/Center, Oncology, Radiation |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2009-12-11 |