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Organization
PAIN MANAGEMENT AND WELLNESS INSTITUTE, PLLC
Active
Organization
PAIN MANAGEMENT AND WELLNESS INSTITUTE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALLIN JENKINS (MANAGER)
(480) 265-0890
Entity
Organization
Contact information
Practice address
10810 N TATUM BLVD, SUITE 102-302, PHOENIX, AZ 85028-6055
(602) 740-1333
Mailing address
10810 N TATUM BLVD, SUITE 102-302, PHOENIX, AZ 85028-6055
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
04/23/2016
Last updated
12/05/2018
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