Organization
PAIN SOLUTIONS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CINDY D GOLLIHAR (MANAGER)
(623) 486-1510
Entity
Organization
Contact information
Practice address
15262 N 75TH AVE, SUITE 400, PEORIA, AZ 85381-4763
(623) 486-1510
(623) 486-1529
Mailing address
15262 N 75TH AVE, SUITE 400, PEORIA, AZ 85381-4763
(623) 486-1510
(623) 486-1529
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OTC4813
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0159630
BLUE CROSS BLUE SHIELD AZ
AZ
Enumeration date
03/07/2007
Last updated
03/09/2011
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