| NPI | 1346461100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE DALE MARTIN Owner ,Operator 816-500-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: 72262) |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: 72262) |
| 246Z00000X Specialist/Technologist, Other (Licence: 72262) | |
| 2471S1302X Radiologic Technologist, Sonography (Licence: 72262) | |
| 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: 72262) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |