PROVIDENCE HEALTH GROUP LLC

PHOENIX, AZ
NPI1841487709
Doing Business AsGENESIS WELLNESS & PAIN MANAGEMENT CENTER
Entity TypeOrganization
Authorized ContactROGER B OLADE
Owner/Physician
404-441-8752
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies208VP0000X Pain Medicine, Pain Medicine
Enumeration Date2007-09-25
Last Update Date2011-06-21
Business Address
PROVIDENCE HEALTH GROUP LLC
300 W OSBORN RD STE 110
PHOENIX, AZ 85013-3922
Phone number: 602-265-1210
Mailing Address
PROVIDENCE HEALTH GROUP LLC
300 W OSBORN RD STE 110
PHOENIX, AZ 85013-3922
Phone number: 602-265-1210