| NPI | 1942755012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON KELLY Owner/Manager 520-309-8312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: AZ 00096509) |
| Additional Taxonomies | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: AZ CRT-11630) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |