| NPI | 1649398751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN HORTON LANE Owner 910-620-9097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory (Licence: NC 279513) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: NC 112625) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2015-05-15 |