Organization
SOUTHWEST PHYSICIAN MEDICAL DIAGNOSTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN MINTER (AGENT)
(702) 256-3637
Entity
Organization
Contact information
Practice address
7341 W CHARLESTON BLVD STE 170, LAS VEGAS, NV 89117-1578
(702) 302-1460
Mailing address
PO BOX 370127, LAS VEGAS, NV 89137-0127
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
8323
NV
Other
Enumeration date
08/18/2017
Last updated
06/16/2018
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