| NPI | 1790732535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA L LILLY President 757-773-8120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: VA 106459) |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: OH 71736) |
| 2471S1302X Radiologic Technologist, Sonography (Licence: VA 36302) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2008-05-20 |