Organization
CANYON PAIN SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY SMITH (ADMINISTRATOR)
(480) 565-5925
Entity
Organization
Contact information
Practice address
4540 E BASELINE RD STE 117, MESA, AZ 85206-4617
(480) 561-0446
(480) 608-4762
Mailing address
4540 E BASELINE RD STE 117, MESA, AZ 85206-4617
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/11/2023
Last updated
08/27/2024
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