Provider Demographics
NPI:1922461912
Name:ARIZONA PAIN AND INJURY CENTERS, INC
Entity Type:Organization
Organization Name:ARIZONA PAIN AND INJURY CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:ISEKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-363-0571
Mailing Address - Street 1:3140 N 35TH AVE
Mailing Address - Street 2:1
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-5269
Mailing Address - Country:US
Mailing Address - Phone:480-719-0853
Mailing Address - Fax:
Practice Address - Street 1:3140 N 35TH AVE
Practice Address - Street 2:1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-5269
Practice Address - Country:US
Practice Address - Phone:480-719-0853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30855111N00000X
CA16440111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty