| NPI | 1710579461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MOSHIRI Manager 602-441-3573 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 208100000X Physical Medicine & Rehabilitation | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2022-02-24 |