| NPI | 1518472950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANZ TABORA Owner/Member Manager 928-460-7226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 293D00000X Physiological Laboratory |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2023-11-03 |