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Organization
SOUTHWEST PET INSTITUTE, LLC
Active
Organization
SOUTHWEST PET INSTITUTE, LLC
Active
Other names
Southwest PEt Institute
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI ALEXANDER (DIRECTOR OF OPERATIONS)
(760) 912-1878
Entity
Organization
Contact information
Practice address
1951 W 25TH ST, SUITE G, YUMA, AZ 85364-6925
(928) 314-4800
(928) 314-4833
Mailing address
1951 W 25TH ST, SUITE G, YUMA, AZ 85364-6925
(928) 314-4800
(928) 314-4833
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
OTC4028
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
991712
—
AZ
01
—
AZ0886210
BCBSAZ
—
Enumeration date
05/05/2006
Last updated
12/20/2007
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