Organization
ARROWHEAD INTERVENTIONAL TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN VIGNEAU (SOLE MBR)
(480) 566-9755
Entity
Organization
Contact information
Practice address
6320 W UNION HILLS DR STE 1400B, GLENDALE, AZ 85308
(623) 688-5400
Mailing address
PO BOX 11180, TEMPE, AZ 85284-0020
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
8494
AZ
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
07/10/2018
Last updated
06/07/2019
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