| NPI | 1902328727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH AARON JANSEN Member 405-249-7672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 293D00000X Physiological Laboratory |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2017-11-27 |