| NPI | 1457870099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DURU Owner 678-698-5725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2020-11-19 |