Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Radiology |
261QR0200X | 74 | Radiation Therapy Center |
| NPI Number | 1164780144 |
| LBN Legal business name | PRESENCE AMBULATORY SERVICES |
| Authorized official | MELVONNE WICKLIFFE-JONES - (CREDENTIALING MGR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/27/2012 |
| Last updated | 05/29/2013 - About 13 years ago |
| Identifiers | n/a |
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