| NPI | 1316139231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD STEVEN RONEY Chief Manager 870-732-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2008-06-02 |