| NPI | 1457416414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT DONALD GOODMAN Co Owner 602-944-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 3984) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: AZ 11336) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2019-06-24 |