NPI: 1235616152
Provider Name: COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC
Doing Business As: COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC - FLAGSTAFF
Classification: Radiology - 2085R0204X
Entity Type: Organization
Specialization: Vascular & Interventional Radiology
CLIA Number: 03D2143743
Address:
2301 N 4TH ST
FLAGSTAFF, AZ
ZIP 86004
Phone: (928) 719-7400
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COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC is a vascular and interventional radiology radiology in Flagstaff, AZ. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC NPI is 1235616152. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Comprehensive Interventional Care Centers, Pllc - Flagstaff.
The provider's business location address is:
2301 N 4TH ST
FLAGSTAFF, AZ
ZIP 86004
Phone: (928) 719-7400
Fax: (480) 371-1121
The provider's authorized official is Joel R. Rainwater .
The authorized official title is President and has the following contact phone number (480) 374-7354.
The CLIA number assigned to this NPI record is 03D2143743 - other - office based lab with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/24/2018 and was last updated on 12/22/2020.