NPI | 1902403264 |
---|---|
Doing Business As | PROFESSIONAL PARK DIAGNOSTICS PLLC, , RADIOLOGY |
Entity Type | Organization |
Authorized Contact | DEBRA T MATTINGLY Credentialing Manager 270-852-8931 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
Enumeration Date | 2020-10-08 |
Last Update Date | 2020-10-15 |