| NPI | 1649634395 |
|---|---|
| Doing Business As | ONCOLOGY CENTER AT PROVIDENCE PARK |
| Entity Type | Organization |
| Authorized Contact | TODD KENNEDY President 251-633-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2016-04-08 |