| NPI | 1194249490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN T SWERIDUK Medical Director 800-258-4674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2017-07-28 |