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Organization

AZ PAIN MEDICINE CLINIC, LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON MOORE (ADMINISTRATOR)
(602) 368-8800
Entity
Organization

Contact information

Practice address
8805 N 23RD AVE STE 160, PHOENIX, AZ 85021-4116
(602) 368-8800
(602) 368-8801
Mailing address
8805 N 23RD AVE STE 160, PHOENIX, AZ 85021-4116
(602) 368-8800
(602) 368-8801

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary

Other

Enumeration date
07/08/2021
Last updated
07/08/2021
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