Healthcare Provider Details

I. General information

NPI: 1063783603
Provider Name (Legal Business Name): DIABETIC AND NEUROPATHY TREATMENT CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8591 E BELL RD STE 102
SCOTTSDALE AZ
85260-1305
US

IV. Provider business mailing address

8591 E BELL RD STE 102
SCOTTSDALE AZ
85260-1305
US

V. Phone/Fax

Practice location:
  • Phone: 480-459-5992
  • Fax: 866-611-9440
Mailing address:
  • Phone: 480-459-5992
  • Fax: 866-611-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL MAGUIRE
Title or Position: CO-OWNER
Credential:
Phone: 510-928-5544