| NPI | 1235401480 |
|---|---|
| Doing Business As | SOUTHSIDE OFFICE |
| Entity Type | Organization |
| Authorized Contact | EDWARD J GOODEMOTE CEO 863-577-0303 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2016-11-03 |