# PHYSICAL MEDICINE CENTERS OF ARIZONA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Laveen Physical Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194026039
- **Authorized official:** JEROD BOWEN PT (OWNER)
- **Authorized official phone:** (602) 237-1105

## Contact information

- **Practice address:** 5045 W BASELINE RD STE 120, SUITE 120, LAVEEN, AZ 85339-7393
- **Practice address phone:** (602) 237-1105
- **Practice address fax:** (602) 237-1106
- **Mailing address:** 5045 W BASELINE RD STE 120, SUITE 120, LAVEEN, AZ 85339-7393
- **Mailing address phone:** (602) 237-1105
- **Mailing address fax:** (602) 237-1106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/09/2010
- **Last updated:** 03/05/2012