# CACTUS PAIN RELIEF, LLC

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

## Provider details

- **NPI number:** 1366049025
- **Authorized official:** BRANDON KULP (OWNER)
- **Authorized official phone:** (623) 225-7154

## Contact information

- **Practice address:** 20255 N LAKE PLEASANT RD STE 102, PEORIA, AZ 85382-9747
- **Practice address phone:** (623) 225-7154
- **Practice address fax:** (623) 376-8225
- **Mailing address:** 20255 N LAKE PLEASANT RD STE 102, PEORIA, AZ 85382-9747
- **Mailing address phone:** (623) 225-7154
- **Mailing address fax:** (623) 376-8225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 10/06/2020
- **Last updated:** 10/06/2020