Organization
ALLIED INTERVENTIONAL CENTER, LLC
Active
Organization
ALLIED INTERVENTIONAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAMBLEN DEAN FULLER (AUTHORIZED OFFICIAL)
(602) 793-0310
Entity
Organization
Contact information
Practice address
14780 W MOUNTAIN VIEW BLVD, #120, SURPRISE, AZ 85374
(314) 973-9571
Mailing address
14780 W MOUNTAIN VIEW BLVD, #120, SURPRISE, AZ 85374-4799
(314) 973-9571
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/28/2016
Last updated
08/22/2018
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