| NPI | 1679648372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA LYNN UZZELL Project Manager 904-535-8125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2022-07-15 |