| NPI | 1194289603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS BLANK Contracting & Credentialing Manager 262-875-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Additional Taxonomies | 2472E0500X Technician, Other, EEG |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic | |
| 293D00000X Physiological Laboratory | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2024-10-31 |