| NPI | 1700456274 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JUSTIN COWLEY Managing Partner 385-492-4064  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology | 
| Enumeration Date | 2021-06-28 | 
| Last Update Date | 2021-07-28 |