| NPI | 1720919459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN BRNICH Manager 267-331-2710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2026-05-29 |
| Last Update Date | 2026-05-29 |