| NPI | 1932683257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN VAUGHN Vice President, Provider Enrollment 330-309-6984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085N0904X |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2025-08-14 |