NPI | 1245824929 |
---|---|
Entity Type | Organization |
Authorized Contact | LACY MARLATT Owner/Partner 208-902-2620 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound |
Enumeration Date | 2021-02-23 |
Last Update Date | 2023-01-03 |