Organization · NPI-2

Cactus Pain Relief, LLC

Anesthesiology, Pain Medicine · Peoria, AZ

NPI number1366049025
StatusActive
Last updated in NPPESOct 6, 2020

Details

NPI
1366049025
Entity type
Organization (NPI-2)
Legal business name
Cactus Pain Relief, LLC
Organization subpart
No
Enumeration date
Oct 6, 2020
Certification date
Oct 6, 2020
Last updated
Oct 6, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207LP2900X Anesthesiology, Pain Medicine––Yes
208D00000X General Practice––

Practice location

20255 N Lake Pleasant Rd Ste 102
Peoria, AZ 85382-9747

Phone 623-225-7154 · Fax 623-376-8225

Mailing address

20255 N Lake Pleasant Rd Ste 102
Peoria, AZ 85382-9747

Phone 623-225-7154 · Fax 623-376-8225

Authorized official

Brandon Kulp
Owner
6232257154

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Anesthesiology, Pain Medicine providers in Peoria, AZ