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General NPI Number Information
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NPI Number | 1194009225
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN CLINIC LLC
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 33747 N SCOTTSDALE RD SUITE 135
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City | SCOTTSDALE
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State | AZ
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Zip | 85266-1565
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Country | US
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Telephone | 480-248-6160
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Fax | 480-284-4180
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Provider Business Mailing Address
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Address Line | 33747 N SCOTTSDALE RD SUITE 135
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City | SCOTTSDALE
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State | AZ
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Zip | 85266-1565
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Country | US
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Telephone | 480-248-6160
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Fax | 480-284-4180
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM B. COOPER
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Credential |
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Telephone | 480-248-6160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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