Organization
OPTIMUM MOBILE IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE COLLETT (OPERATING MANAGER)
80188477812
Entity
Organization
Contact information
Practice address
1411 W MAPLEWOOD ST, CHANDLER, AZ 85286-6972
(877) 343-2783
(888) 376-9730
Mailing address
PO BOX 27340, PHOENIX, AZ 85061-7340
(602) 943-9200
(602) 216-3000
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158098
—
AZ
Enumeration date
10/24/2006
Last updated
07/26/2012
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