| NPI | 1750941902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA K MILLER Dir Of Billing 765-446-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0206X Clinic/Center, Radiology, Mammography |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-07-23 |