| NPI | 1235265307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT SCHUMAN Credentialing Specialist 304-929-6930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: WV 3400) |
| Additional Taxonomies | 261QR0208X Clinic/Center, Radiology, Mobile (Licence: WV 3400) |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2017-11-06 |