| NPI | 1528940939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE FENSTERMACHER Credentialing Manager 346-347-1673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0203X Clinic/Center, Oncology, Radiation |
| Enumeration Date | 2025-07-24 |
| Last Update Date | 2025-07-28 |