| NPI | 1649383910 |
|---|---|
| Doing Business As | PROVENA HEALTH CENTER FOR DIAGNOSTIC IMAGING |
| Entity Type | Organization |
| Authorized Contact | EDWARD MOLARE President 952-525-6338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |