Healthcare Provider Details

I. General information

NPI: 1891173415
Provider Name (Legal Business Name): ARIZONA CENTER FOR PAIN RELIEF, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 05/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 E PIMA CENTER PKWY SUITE 1
SCOTTSDALE AZ
85258-4613
US

IV. Provider business mailing address

9015 E PIMA CENTER PKWY SUITE 1
SCOTTSDALE AZ
85258-4613
US

V. Phone/Fax

Practice location:
  • Phone: 602-431-1152
  • Fax: 602-431-2149
Mailing address:
  • Phone: 602-431-1152
  • Fax: 602-431-2149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KIRSTEN ANN SORENSEN
Title or Position: CREDENTIALING
Credential:
Phone: 602-431-1152