Organization
SOUTHWEST CENTERS FOR REGENERATIVE MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA MANKIN (ADMINISTRATOR)
(602) 510-3203
Entity
Organization
Contact information
Practice address
2629 N SCOTTSDALE RD STE 100, SCOTTSDALE, AZ 85257-1370
(602) 510-3203
(602) 297-6997
Mailing address
2629 N SCOTTSDALE RD STE 100, SCOTTSDALE, AZ 85257-1370
(602) 510-3203
(602) 297-6997
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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