# PAINX JOINT- REVITALIZATION INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PainX
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306404454
- **Authorized official:** MS. LISA AMAYA PA-C (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (602) 828-6705

## Contact information

- **Practice address:** 62 N STAPLEY DR STE B, MESA, AZ 85203-8845
- **Practice address phone:** (602) 828-6705
- **Practice address fax:** (602) 581-7160
- **Mailing address:** 62 N STAPLEY DR STE B, MESA, AZ 85203-8845
- **Mailing address phone:** (602) 828-6705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 06/04/2019
- **Last updated:** 03/05/2020