| NPI | 1740600600 |
|---|---|
| Doing Business As | MOBILE DIAGNOSTIC IDTF |
| Entity Type | Organization |
| Authorized Contact | DENISE K STROOBANTS Credentialing Specialist 920-433-7864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Additional Taxonomies | 261QR0207X Clinic/Center, Radiology, Mobile Mammography |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2021-10-18 |