| NPI | 1538162334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DOUGLAS Credentialing Manager 502-477-1815 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2008-06-12 |