| NPI | 1821066648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR COLLADO Radiologist 313-962-2133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: MI 24834) |
| Additional Taxonomies | 293D00000X Physiological Laboratory |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| 261QR0200X Clinic/Center, Radiology | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2011-05-04 |