| NPI | 1487156949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL R WAGNER Treasurer 215-856-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |