| NPI | 1215931290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LOPERANO Administration 870-910-6654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AR MC0222) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2011-08-31 |