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General NPI Number Information
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NPI Number | 1538656301
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Entity Type | Organization
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Legal Business Name | PHOENIX SPINE SCOTTSDALE ASC, LLC
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 9700 N 91ST ST STE C100
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5054
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Country | US
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Telephone | 602-256-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 E ARIZONA BILTMORE CIR STE D142
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City | PHOENIX
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State | AZ
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Zip | 85016-2147
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Country | US
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Telephone | 602-256-2525
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Fax | 602-256-0795
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | MS. DEB SWATON
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Credential |
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Telephone | 602-256-2525
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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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