| NPI | 1477551653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE TRAVIS LUTZ Manager Of Credentialing 704-362-5391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: NJ 429966) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2022-06-01 |