| NPI | 1639825565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL B DECKER Owner/Manager 336-721-1487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-03-01 |