| NPI | 1912185927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CLARK Owner 662-514-5215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: MS MRT2279) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2008-12-03 |