Organization
PAINCARE OF ARIZONA II, LLC
Active
Organization
PAINCARE OF ARIZONA II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SKY C MOORE D.C. (OWNER)
(602) 488-4558
Entity
Organization
Contact information
Practice address
14175 W INDIAN SCHOOL RD, SUITE B-4-517, GOODYEAR, AZ 85395-8407
(602) 488-4558
Mailing address
14175 W INDIAN SCHOOL RD, SUITE B-4-517, GOODYEAR, AZ 85395-8407
(602) 488-4558
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
4249
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4249
OTC
AZ
Enumeration date
06/25/2008
Last updated
06/25/2008
Update your record
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