Organization
PEORIA PAIN PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA D GOLLIHAR (MANAGER)
(623) 486-1510
Entity
Organization
Contact information
Practice address
15262 N 75TH AVE, SUITE 400 A, PEORIA, AZ 85381-4763
(623) 486-1510
(623) 486-1529
Mailing address
15262 N 75TH AVE, SUITE 400 A, PEORIA, AZ 85381-4763
(623) 486-1510
(623) 486-1529
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z138995
PTAN
AZ
Enumeration date
02/08/2010
Last updated
10/21/2014
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