| NPI | 1326283383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL DEIDIKER Provider 888-275-9737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |