| NPI | 1679679955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL DAVID BLANTON Presidet 772-335-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2020-08-22 |