Name | Value |
---|---|
PROVIDER TYPE | Technologists, Technicians & Other Technical Service Providers |
CLASSIFICATION | Radiologic Technologist |
AREA OF SPECIALIZATION | Mammography |
STATUS | Active |
VA CODE | V150308 |
X12 CODE | 2471M2300X |
INDIVIDUAL/NON | INDIVIDUAL |
MASTER ENTRY FOR VUID | YES |
VUID | 5255714 |
EFFECTIVE DATE/TIME |
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