| NPI | 1275084188 |
|---|---|
| Doing Business As | CCS PHYSICIAN CLINIC |
| Entity Type | Organization |
| Authorized Contact | TROY WELLS President 501-202-2080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |