| NPI | 1487415741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA HORSFALL Director Of Provider Enrollment 800-258-4674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-09-23 |