| NPI | 1639410418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ELLIS Owner 706-271-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 39706) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2014-10-08 |