Individual
LAVERNE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.T. (R)(M)
Contact information
Practice address
167 N. MAIN ST., TUBA CITY, AZ 86045
(928) 283-2198
(928) 283-1312
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2198
(928) 283-1312
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
14515
AZ
2471M2300X
Mammography Radiologic Technologist
Primary
2777
AZ
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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