| NPI | 1659536100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIS H MADDUX Owner 843-301-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: SC 79645) |
| Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography (Licence: SC 79645) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |