Provider Demographics
NPI:1952654154
Name:EV PAIN SPECIALISTS
Entity Type:Organization
Organization Name:EV PAIN SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLLIHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-486-1510
Mailing Address - Street 1:18610 E RITTENHOUSE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4503
Mailing Address - Country:US
Mailing Address - Phone:623-486-1510
Mailing Address - Fax:623-486-1529
Practice Address - Street 1:14100 N 83RD AVE STE 260
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5659
Practice Address - Country:US
Practice Address - Phone:623-486-1510
Practice Address - Fax:623-486-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty