NPI | 1982685178 |
---|---|
Entity Type | Organization |
Authorized Contact | BEN G BOSTICK Supervising Physician 256-734-3141 |
Organization Subpart ? | No |
Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: AL 01D0300133) |
Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
Enumeration Date | 2005-11-07 |
Last Update Date | 2023-08-31 |