| NPI | 1871667014 |
|---|---|
| Doing Business As | PHOENIX SPINE GOODYEAR ASC, LLC |
| Entity Type | Organization |
| Authorized Contact | ERIC BOON AO 480-567-0269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 28519) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 35838) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2024-09-05 |