NPI | 1629265806 |
---|---|
Entity Type | Organization |
Authorized Contact | KAREN MARIE VAUGHN Vice President, Provider Enrollment 330-309-6984 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
Enumeration Date | 2007-10-01 |
Last Update Date | 2025-09-04 |