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Organization
NORTH VALLEY PAIN CENTER PLLC
Active
Organization
NORTH VALLEY PAIN CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH BANGART DPM (OWNER)
(602) 595-7228
Entity
Organization
Contact information
Practice address
15650 N BLACK CANYON HWY # B121, PHOENIX, AZ 85053-4064
(602) 595-7228
(602) 391-2770
Mailing address
7558 W THUNDERBIRD ROAD, STE 1 BOX 606, PEORIA, AZ 85381-6080
(602) 595-7228
(602) 391-2770
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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