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General NPI Number Information
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NPI Number | 1336386465
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN ASSOCIATES LLC
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 5102 W CAMPBELL AVE
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City | PHOENIX
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State | AZ
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Zip | 85031-1703
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Country | US
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Telephone | 602-267-1779
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Fax | 602-277-8146
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Provider Business Mailing Address
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Address Line | P.O. BOX 39179
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City | PHOENIX
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State | AZ
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Zip | 85069
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Country | US
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Telephone | 602-395-0718
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LESLIE DIGGES
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Credential |
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Telephone | 602-395-0718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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