Organization
MEDELA VIDA LLC
Active
Other names
PIBCOA - The Pain, Injury & Brain Centers of America
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY DEAN BINGHAM (OWNER)
(480) 331-0046
Entity
Organization
Contact information
Practice address
6020 E BROWN RD STE 104, MESA, AZ 85205-4812
(602) 428-0700
Mailing address
6020 E BROWN RD STE 104, MESA, AZ 85205-4812
(602) 428-0700
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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