Organization
NOVASPINE PAIN INSTITUTE, PLC
Active
Parent organization
NOVASPINE PAIN INSTITUTE, PLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NOVASPINE PAIN INSTITUTE, PLC
Authorized official
HEATHER SPENCER (PRACTICE ADMIN)
(623) 777-4747
Entity
Organization
Contact information
Practice address
17100 N 67TH AVE STE 300, GLENDALE, AZ 85308-3657
(623) 777-4747
Mailing address
PO BOX 5068, SUN CITY WEST, AZ 85376-5068
(623) 777-4747
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z166942
GROUP MEDICARE NUMBER
AZ
Enumeration date
02/15/2024
Last updated
02/15/2024
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