Organization
MPM GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT GOODMAN (MANAGER)
(602) 944-2222
Entity
Organization
Contact information
Practice address
11047 N 19TH AVE, PHOENIX, AZ 85029-4816
(602) 944-2222
Mailing address
11047 N 19TH AVE, PHOENIX, AZ 85029-4816
(602) 944-2222
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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