| NPI | 1619158862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL STEVEN JACOBUS Owner 803-917-2988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2016-03-23 |