| NPI | 1487904173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY OLIVER Manager 662-832-3514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E7789) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2023-07-05 |