| NPI | 1952778474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI R HENSON Executive Director 618-463-8534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0206X Clinic/Center Radiology, Mammography |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-01 |