| NPI | 1568891364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA L JESSUP Member Manager 910-880-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy | |
| 207U00000X Nuclear Medicine | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| 247100000X Radiologic Technologist | |
| 2471N0900X Radiologic Technologist, Nuclear Medicine Technology | |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic | |
| 293D00000X Physiological Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2018-03-17 |