| NPI | 1225159643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA MALADY Billing 901-737-3071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TN MD6355) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |