| NPI | 1992257836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL System Credentialing Enrollments 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2020-03-31 |