| NPI | 1780152215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM G WITTENBORN Manager 573-331-3080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center Radiology |
| Additional Taxonomies | 335V00000X Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |