| NPI | 1902809064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DOUGLAS Credentialing Manager 502-477-1815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-08-22 |