| NPI | 1821571399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE-DEE GARDNER BARTROM President 765-228-4660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2020-04-17 |