Organization
AZ MOBILE IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE S. COON (OWNER)
(628) 536-6012
Entity
Organization
Contact information
Practice address
560 S 1ST ST W, SNOWFLAKE, AZ 85937-5223
(928) 634-0665
(928) 634-0337
Mailing address
PO BOX 4198, COTTONWOOD, AZ 86326-2570
(928) 634-0665
(928) 634-0337
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010058
—
AZ
Enumeration date
05/03/2006
Last updated
11/07/2007
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