NPI | 1477506319 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDY R FISCHER Executive Officer 765-446-5292 |
Organization Subpart ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
Enumeration Date | 2006-05-19 |
Last Update Date | 2020-08-22 |