Organization
IMAGING CENTER OF CLOVIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANANNE MAZZOLINI RT( R)( M) (OWNER)
(575) 693-3770
Entity
Organization
Contact information
Practice address
2105 W 21ST ST, CLOVIS, NM 88101-4017
(575) 935-9729
(575) 935-9731
Mailing address
2105 W 21ST ST, CLOVIS, NM 88101-4017
(575) 935-9729
(575) 935-9731
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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