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Organization
TADA SOUTHWEST SPINE LLC
Active
Organization
TADA SOUTHWEST SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT TAYLOR DC (MEMBER/OWNER)
(480) 354-2008
Entity
Organization
Contact information
Practice address
4540 E BASELINE RD STE 119, MESA, AZ 85206-4617
(480) 354-2008
Mailing address
2919 S ELLSWORTH RD STE 102, MESA, AZ 85212-2165
(480) 354-2008
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/25/2020
Last updated
12/17/2020
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