| NPI | 1184278483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN JOSEPH POLSELLI Owner 912-667-8654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0207X Clinic/Center, Radiology, Mobile Mammography |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2022-09-26 |