| NPI | 1487794186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A PANKEY Owner 904-992-9749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile (Licence: FL HCC6547) |
| Additional Taxonomies | 261QR0208X Clinic/Center, Radiology, Mobile (Licence: AL I3794) |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-10-03 |