Organization
CACTUS PAIN RELIEF, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON KULP (OWNER)
(623) 225-7154
Entity
Organization
Contact information
Practice address
20255 N LAKE PLEASANT RD STE 102, PEORIA, AZ 85382-9747
(623) 225-7154
(623) 376-8225
Mailing address
20255 N LAKE PLEASANT RD STE 102, PEORIA, AZ 85382-9747
(623) 225-7154
(623) 376-8225
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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