Organization
TRAUMA & RECONSTRUCTIVE UPPER EXTREMITY SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE C WHITE CPA (CPA AGENT)
(602) 222-5611
Entity
Organization
Contact information
Practice address
370 E VIRGINIA AVE STE 100, PHOENIX, AZ 85004-1254
(602) 222-5611
Mailing address
370 E VIRGINIA AVE STE 100, PHOENIX, AZ 85004-1254
(602) 222-5611
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
28314
AZ
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
28314
AZ
2086S0122X
Plastic and Reconstructive Surgery Physician
28314
AZ
Other
Enumeration date
10/28/2015
Last updated
12/28/2015
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