| NPI | 1407560196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN LAWRENCE Mgr Member 877-318-1349 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 261QR0206X Clinic/Center, Radiology, Mammography |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2025-02-10 |