| NPI | 1497624332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BRUCE TANNEHILL Den 706-651-6105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 2086S0129X |
| Enumeration Date | 2025-10-30 |
| Last Update Date | 2025-10-30 |