| NPI | 1740610039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN RENEAU Practice Administrator 602-802-8636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine |
| 207XS0106X Orthopaedic Surgery Hand Surgery | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2017-11-15 |