Marjorie Chinnock, ARRT

Individual provider Active NPI Radiologic Technologist · Polacca, AZ

NPI 1891010807 · NPPES record last updated Apr 1, 2010

Key facts

NPI
1891010807
Entity type
Individual (NPI type 1)
Primary specialty
Radiologic Technologist 247100000X
License
CRT - 12784 (AZ)
Practice address
M.P. 388 State Route 264
Polacca, AZ 86042-4000
Phone
(928) 737-6000
Fax
(928) 737-6069
NPI assigned
Apr 1, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CRT - 12784AZMDRadiologic Technologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X CRT - 12784 AZ Yes

Addresses

Primary practice location

M.P. 388 State Route 264
Polacca, AZ 86042-4000

Mailing address

PO Box 4000
Polacca, AZ 86042-4000
Phone (928) 737-6000

Other providers in Polacca, AZ

All providers in Polacca, AZ · Radiologic Technologist in Arizona

Sources for this page

Verify at the official NPI Registry.