| NPI | 1851641567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY LEE RUSSELL Owner/Operator 615-522-1094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Additional Taxonomies | 247100000X Radiologic Technologist |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2016-09-23 |