| NPI | 1750513016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARELYN BERTINA JACKSON President/CEO 863-299-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2010-11-05 |