Business Name
Physician First Name
*Phoenix 102
Physician Last Name
SMI Imaging LLC
Practice Name
Specialty
Ancillary
Office Designation
Primary
Address
2620 N. 3rd Street
85004-1153
85004-1153
Suite
Suite 102
City
Phoenix
State
AZ
County
Maricopa
Business Phone Number
(602)234-2994
Business Website Address
Business Fax
(602)302-5932
ASPA Effective Date
10/3/2016