Organization
PUEBLO RADIOLOGY LLC
Active
Organization
PUEBLO RADIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL ALAN DERHAAG (MANAGER)
(520) 352-7600
Entity
Organization
Contact information
Practice address
1313 W SAINT MARYS RD, TUCSON, AZ 85745-3112
(520) 352-7600
(520) 352-7610
Mailing address
PO BOX 1810, SCOTTSDALE, AZ 85252-1810
(520) 352-7600
(520) 352-7610
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
10/22/2009
Last updated
10/22/2009
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