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General NPI Number Information
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NPI Number | 1407505100
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Entity Type | Organization
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Legal Business Name | MOBILE MEDICAL DIAGNOSTICS LLC
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 10869 N SCOTTSDALE RD PMB602 SCOTTSDALE, AZ 8 STE 103
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City | SCOTTSDALE
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State | AZ
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Zip | 85254
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Country | US
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Telephone | 480-737-4206
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Fax |
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Provider Business Mailing Address
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Address Line | 10869 N SCOTTSDALE RD PMB602 SCOTTSDALE, AZ 8 STE 103
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City | SCOTTSDALE
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State | AZ
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Zip | 85254
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RADIOLOGY TECH/SONOGRAPHY
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Name | MAKENZIE E. TEICHERT
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Credential |
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Telephone | 480-737-4206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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