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General NPI Number Information
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NPI Number | 1861964686
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Entity Type | Organization
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Legal Business Name | CHOICE PAIN SOLUTIONS TREATMENT CENTER
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 10565 N TATUM BLVD STE B115
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-1095
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Country | US
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Telephone | 602-818-0227
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Fax |
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Provider Business Mailing Address
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Address Line | 10565 N TATUM BLVD STE B115
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-1095
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Country | US
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Telephone | 602-818-0227
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MS. JOANNA SHIELDS
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Credential |
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Telephone | 602-818-0227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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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 | 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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