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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