Organization
16TH STREET SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT COOK (OWNER/MANAGER)
(480) 766-6819
Entity
Organization
Contact information
Practice address
6245 N 16TH ST, PHOENIX, AZ 85016-1706
(480) 766-6819
Mailing address
15333 N PIMA RD STE 305, SCOTTSDALE, AZ 85260-2717
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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