| NPI | 1609102565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD RICHARD SIPE Member 336-274-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2471C3401X Radiologic Technologist Computed Tomography |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2009-10-28 |