| NPI | 1710369228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ERIC PAYNE Member 479-253-4430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile (Licence: AR RTL6981) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2015-06-19 |