Organization
HARRY S. TRUMAN MVH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL GRACIA (DIAGNOSTIC RADIOLOGY TECH)
(419) 822-6931
Entity
Organization
Contact information
Practice address
132 SOUTHAMPTON DR, COLUMBIA, MO 65203-3050
(419) 822-6931
Mailing address
132 SOUTHAMPTON DR, COLUMBIA, MO 65203-3050
(419) 822-6931
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
508605
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
508605
ARRT
—
Enumeration date
04/17/2015
Last updated
04/17/2015
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