| NPI | 1629149414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY RAY BOLTON Owner 318-329-5844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: LA LA5080) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-07-23 |