Healthcare Provider Details

I. General information

NPI: 1083893390
Provider Name (Legal Business Name): ALL VALLEY IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E ROSE LN
PHOENIX AZ
85012-1242
US

IV. Provider business mailing address

209 E ROSE LN
PHOENIX AZ
85012-1242
US

V. Phone/Fax

Practice location:
  • Phone: 602-265-3199
  • Fax: 602-419-2988
Mailing address:
  • Phone: 602-265-3199
  • Fax: 602-419-2988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GREG S PERKINS
Title or Position: VP OPERATIONS
Credential: BS RDMS, NMTCB
Phone: 602-909-6155