Provider First Line Business Practice Location Address:
6958 SW VARNS STREET
Provider Second Line Business Practice Location Address:
SOUTHWEST DIAGNOSTIC IMAGING, LTD
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97223-2530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-683-7730
Provider Business Practice Location Address Fax Number:
39-140-9275
Provider Enumeration Date:
03/22/2006