Organization
THE ORTHO JOINT OF ARIZONA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY TSAO (PROVIDER)
(623) 583-2073
Entity
Organization
Contact information
Practice address
12361 W BOLA DR, #100, SURPRISE, AZ 85378-9021
(623) 584-5626
Mailing address
PO BOX 1149, PEORIA, AZ 85380
(623) 583-2073
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AZ
Enumeration date
06/14/2013
Last updated
06/17/2013
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