| NPI | 1235795352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK BRIAN GIPE Partner 270-685-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261QR0200X Clinic/Center Radiology |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-12-19 |