| NPI | 1992429443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE WEBSTER Owner 906-202-9378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 2471V0105X Radiologic Technologist, Vascular Sonography |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-09-28 |