| NPI | 1902430481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA SUZANN CAMPBELL Billing Manager 573-634-7155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-02-24 |