| NPI | 1386384360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARDNER BARTROM President 765-228-4660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QR0200X Clinic/Center, Radiology | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2024-01-08 |