| NPI | 1356706774 |
|---|---|
| Doing Business As | TRISTATE PAIN INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | JOANN VENGER Owner/Member Manager 928-788-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 207T00000X Neurological Surgery (Licence: AZ 20605) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 208VP0000X (Licence: AZ 20605) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 363L00000X Nurse Practitioner (Licence: AZ AP3760) | |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2022-07-19 |