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General NPI Number Information
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NPI Number | 1821989708
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Entity Type | Organization
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Legal Business Name | SOUTHERN ARIZONA LIMB PRESERVATION CENTER LLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 6130 N LA CHOLLA BLVD STE 111
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City | TUCSON
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State | AZ
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Zip | 85741-3589
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Country | US
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Telephone | 310-919-9560
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Fax |
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Provider Business Mailing Address
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Address Line | 6130 N LA CHOLLA BLVD STE 111
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City | TUCSON
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State | AZ
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Zip | 85741-3589
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Country | US
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Telephone | 310-919-9560
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. DIANE L BOONE
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Credential | RN MS
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Telephone | 310-919-9560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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