| NPI | 1710100839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP FORST Owner 207-497-2996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: ME RT3575) |
| Additional Taxonomies | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2019-12-24 |