Organization
WHITE MOUNTAIN IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN HOEFLE (BOARD MEMBER)
(928) 537-2077
Entity
Organization
Contact information
Practice address
5448 HIGHWAY 260, LAKESIDE, AZ 85929-5739
(928) 537-2077
(928) 537-5282
Mailing address
5448 HIGHWAY 260, LAKESIDE, AZ 85929-5739
(928) 537-2077
(928) 537-5282
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
OTC5724
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
918972
—
AZ
Enumeration date
12/29/2005
Last updated
08/22/2020
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