| NPI | 1386375194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE COATES Manager 574-210-2473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-06-28 |