# WIDE OPEN MRI OF BULLHEAD CITY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639105893
- **Authorized official:** JASON A CYRUS (OWNER)
- **Authorized official phone:** (928) 704-0080

## Contact information

- **Practice address:** 2000 HIGHWAY 95, SUITE 222, BULLHEAD CITY, AZ 86442-6050
- **Practice address phone:** (928) 704-0080
- **Practice address fax:** (928) 704-1654
- **Mailing address:** 2000 HIGHWAY 95, SUITE 222, BULLHEAD CITY, AZ 86442-6050
- **Mailing address phone:** (928) 704-0080
- **Mailing address fax:** (928) 704-1654

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/22/2006
- **Last updated:** 06/07/2011