| NPI | 1558482562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN J MOLE Practice Manager 276-623-8105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101023208) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |