# TADA SOUTHWEST SPINE LLC

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

## Provider details

- **NPI number:** 1528662079
- **Authorized official:** SCOTT TAYLOR DC (MEMBER/OWNER)
- **Authorized official phone:** (480) 354-2008

## Contact information

- **Practice address:** 4540 E BASELINE RD STE 119, MESA, AZ 85206-4617
- **Practice address phone:** (480) 354-2008
- **Mailing address:** 2919 S ELLSWORTH RD STE 102, MESA, AZ 85212-2165
- **Mailing address phone:** (480) 354-2008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/25/2020
- **Last updated:** 12/17/2020