| NPI | 1821861378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER REED Administrator 662-335-4105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-16 |