Organization
GLENDALE PAIN TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH CLARK DPM (OWNER)
(801) 448-4841
Entity
Organization
Contact information
Practice address
18301 N 79TH AVE STE F168, GLENDALE, AZ 85308-6045
(602) 675-0478
(602) 675-0479
Mailing address
18301 N 79TH AVE STE F168, GLENDALE, AZ 85308-6045
(602) 675-0478
(602) 675-0479
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
06/22/2021
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