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1144476896
BRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC
COTTONWOOD, AZ
NPI
1144476896
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Entity Type
Organization
Authorized Contact
TOM FELLOWS
President
928-778-7823
Organization Subpart ?
Yes
Primary Taxonomy
291U00000X Clinical Medical Laboratory
Enumeration Date
2008-08-13
Last Update Date
2008-08-13
Business Address
BRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC
203 S CANDY LN SUITE 115-B2
COTTONWOOD, AZ 86326-4120
Phone number: 928-634-0495
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Mailing Address
BRADSHAW MOUNTAIN DIAGNOSTIC LABORATORY INC
990 WILLOW CREEK RD
PRESCOTT, AZ 86301-1640
Phone number: 928-778-7823
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