| NPI | 1366077570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH S THOMAS Doctor 733-881-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-03-09 |