Provider Demographics
NPI:1639763287
Name:PALOVERDE PROFESSIONAL BILLING
Entity Type:Organization
Organization Name:PALOVERDE PROFESSIONAL BILLING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-214-2501
Mailing Address - Street 1:5533 E BELL RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1256
Mailing Address - Country:US
Mailing Address - Phone:602-334-1080
Mailing Address - Fax:602-788-4200
Practice Address - Street 1:5533 E BELL RD STE 111
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1256
Practice Address - Country:US
Practice Address - Phone:602-334-1080
Practice Address - Fax:602-788-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty