NPI age
19 years
Enumerated 2006-12-18
Across 220 active radiology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (KY) | 64797558 | |
| 05 (TN) | 3051403 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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