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Organization

LAKE HAVASU RADIOLOGY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKI CLOUD (BILLING MANAGER)
(337) 721-1961
Entity
Organization

Contact information

Practice address
1200 W MOHAVE RD, PARKER, AZ 85344-6349
(337) 721-1961
Mailing address
PO BOX 1766, LAKE CHARLES, LA 70602-1766
(337) 721-1961
(337) 721-1939

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Enumeration date
06/02/2008
Last updated
06/02/2008
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