| NPI | 1275006744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARI D. GAMBLE Nurae Administrator 618-993-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2022-09-08 |