| NPI | 1184242521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN ANDRIKOPOULOS Director Officer 307-444-4215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2021-09-16 |