Provider Demographics
NPI:1710153903
Name:NES INTEGRATIVE HEALTH MANAGEMENT LLC
Entity Type:Organization
Organization Name:NES INTEGRATIVE HEALTH MANAGEMENT LLC
Other - Org Name:SOUTHWEST INTEGRATIVE PAIN INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-981-6027
Mailing Address - Street 1:12325 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-7105
Mailing Address - Country:US
Mailing Address - Phone:520-981-6027
Mailing Address - Fax:
Practice Address - Street 1:2312 N ROSEMONT BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6114
Practice Address - Country:US
Practice Address - Phone:520-232-9797
Practice Address - Fax:520-232-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty