Organization Name: | EV PAIN SOLUTIONS, LLC |
NPI Number: | 1013213156 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CYNTHIA D. GOLLIHAR (MANAGER) |
Mailing Address: | 18610 E Rittenhouse Rd Suite 101 Queen Creek |
State: | AZ US |
Postal Code: | 851424503 |
Phone Number: | 6234861510 |
Fax Number: | 6234861529 |
NPI Enumeration Date: | 02/08/2011 |
NPI Last Update Date: | 01/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |