NPI: 1699175158 · POCATELLO, ID 83201 · Radiology Clinic/Center · NPI assigned 09/02/2014
| Authorized Official | DAVISON, RANAE (AUTHORIZED OFFICIAL) |
| NPI Enumeration Date | 09/02/2014 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $764.50 |
| 2019 | 26 | $2K |
| 2020 | 25 | $1K |
| 2021 | 12 | $917.40 |
| 2023 | 14 | $374.26 |