| NPI | 1275862161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON FENDERSON Owner 904-707-8614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: FL 1000028650) |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2011-03-30 |