| NPI | 1255789368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTON KENT Medical Director Ideal Image 239-514-7888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL 3063932) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-05-31 |