| NPI | 1790352409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA MAE MASAKOWSKI Business Office Mgr 563-359-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center Radiology |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2021-06-10 |