| NPI | 1851949291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIN RAY MODISETTE Owner 318-475-0690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2022-12-28 |