| NPI | 1982668471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY A SMALL Billing Manager 717-843-8983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS-005338-L) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS008164L) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-08-22 |