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General NPI Number Information
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NPI Number | 1215501374
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Entity Type | Organization
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Legal Business Name | ARIZONA ADVANCED PAIN CENTER
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 4566 E INVERNESS AVE STE 101
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City | MESA
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State | AZ
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Zip | 85206-4633
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Country | US
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Telephone | 480-672-2240
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Fax | 480-865-2737
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Provider Business Mailing Address
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Address Line | 4566 E INVERNESS AVE STE 101
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City | MESA
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State | AZ
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Zip | 85206-4633
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Country | US
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Telephone | 480-672-2240
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Fax | 480-865-2737
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Authorized Official
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Title or Position | OWNER
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Name | JORDAN TENNANT
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Credential | DC
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Telephone | 785-231-9243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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