| NPI | 1659030005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARRETT MICHAEL LEATHEM Do, Owner 480-573-0130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207L00000X Anesthesiology | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2021-12-14 |