| Doctor Name: | LAVERNE KING |
| NPI Number: | 1255578043 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.T. (R)(M) |
| License Number: | 14515 |
| Business Practice Address: | 167 N. Main St. Tuba City, AZ - 86045 |
| Business Phone Number: | 9282832198 |
| Business Fax Number: | 9282831312 |
| Mailing Address: | Po Box 600, TUBA CITY |
| State: | AZ |
| Postal Code: | 860450600 |
| Phone Number: | 9282832198 |
| Fax Number: | 9282831312 |
| NPI Enumeration Date: | 01/15/2009 |
| NPI Last Update Date: | 01/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 247100000X |
| License Number: | 14515 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |