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General NPI Number Information
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NPI Number | 1932644606
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Entity Type | Organization
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Legal Business Name | INNOVATIVE SURGERY CENTER PLC
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 15547 N REEMS RD BLDG A
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City | SURPRISE
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State | AZ
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Zip | 85374-9583
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Country | US
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Telephone | 623-535-9777
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Fax |
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Provider Business Mailing Address
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Address Line | 15547 N REEMS RD BLDG A
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City | SURPRISE
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State | AZ
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Zip | 85374-9583
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Country | US
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Telephone | 623-535-9777
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Fax |
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Authorized Official
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Title or Position | PHYSICAIN/OWNER
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Name | WENDI J LUNDQUIST
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Credential | D.O.
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Telephone | 623-535-9777
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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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