| NPI | 1255385183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE TRAVIS LUTZ Manager Of Credentialing 704-362-5391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2022-08-16 |