| NPI | 1942879192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA LEE FLOYD Director, Risk Management 365-352-2583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-06-23 |