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General NPI Number Information
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NPI Number | 1881230563
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Entity Type | Organization
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Legal Business Name | PCO PC
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 7785 N STATE ST
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City | LOWVILLE
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State | NY
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Zip | 13367-1229
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Country | US
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Telephone | 800-858-5876
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 E CAMELBACK RD STE 250
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City | PHOENIX
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State | AZ
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Zip | 85018-8350
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Country | US
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Telephone | 800-858-5876
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Fax | 951-680-1989
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Authorized Official
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Title or Position | AO
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Name | DR. ALIX VINCENT
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Credential | MD
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Telephone | 949-480-9698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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