# ADVANCED SPINE AND PAIN SURGERY CENTERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023604931
- **Authorized official:** JARRET LEATHEM (OWNER)
- **Authorized official phone:** (480) 573-0210

## Contact information

- **Practice address:** 3525 N CENTRAL AVE, PHOENIX, AZ 85012-2101
- **Practice address phone:** (480) 573-0210
- **Practice address fax:** (480) 573-0211
- **Mailing address:** 2525 W GREENWAY RD STE 125, PHOENIX, AZ 85023-4226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/15/2020
- **Last updated:** 12/15/2020