| NPI | 1982026241 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP MILL PLAIN XRAY |
| Entity Type | Organization |
| Authorized Contact | DONALD W ANDERSON Dir Reimb Reg Strat/Asst Sec Enroll 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2024-02-21 |