MEDICARE: PAIN-X RELIEF CENTERS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	364SF0001X	Family Health Clinical Nurse Specialist
3	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1063813970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN-X RELIEF CENTERS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 11180
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85284-0020
Country	:	US
Telephone Number	:	480-264-3744
Fax Number	:	480-264-2075

Provider Business Practice Location Address
First Line	:	21050 N TATUM BLVD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-4260
Country	:	US
Telephone Number	:	480-585-7463
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. AARON L WIEGAND
Credential	:	DC
Telephone Number	:	480-585-7463

Provider Enumeration Date	:	09/10/2014
Last Update Date	:	09/10/2014

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