| NPI | 1962845438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY FUNK Billing Administrator 877-434-2035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MS 11850) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2020-10-28 |