| NPI | 1578658837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALEB FORT CEO 336-245-0647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: NC 34X0009827) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2017-06-07 |