Organization
DESERT RIDGE PAIN FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKE CORMIER DC (MANAGING PARTNER)
(480) 773-7662
Entity
Organization
Contact information
Practice address
21001 N TATUM BLVD STE 78-1640, PHOENIX, AZ 85050-5244
(480) 773-7662
Mailing address
4300 N MILLER RD STE 240, SCOTTSDALE, AZ 85251-3639
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/06/2021
Last updated
04/06/2021
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