| NPI | 1336529197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD O. CORNWALL President 336-816-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QR0208X Clinic/Center, Radiology, Mobile (Licence: NC 21159) |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: NC 21159) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2018-09-12 |