| NPI | 1588461966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANDRE ANTHONY SMITH CEO 424-505-2109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2025-02-25 |
| Last Update Date | 2026-07-10 |