| NPI | 1689075954 |
|---|---|
| Doing Business As | ONCOLOGY CENTER AT PROVIDENCE PARK |
| Entity Type | Organization |
| Authorized Contact | JAMES L. WALKER President 251-633-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2014-09-05 |