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General NPI Number Information
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NPI Number | 1356940274
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Entity Type | Organization
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Legal Business Name | ARIZONA CENTERS FOR ORTHOBIOLOGICS, LLC
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 610 E BASELINE RD STE 103
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City | TEMPE
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State | AZ
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Zip | 85283-1204
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Country | US
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Telephone | 480-778-1400
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Fax | 602-297-6997
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Provider Business Mailing Address
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Address Line | 610 E BASELINE RD STE 103
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City | TEMPE
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State | AZ
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Zip | 85283-1204
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Country | US
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Telephone | 480-778-1400
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Fax | 602-297-6997
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TINA MANKIN
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Credential |
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Telephone | 602-510-3203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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