COLORADO RIVER PAIN MANAGEMENT LLC NPI 1639405756

NPI Information

COLORADO RIVER PAIN MANAGEMENT LLC is a pain clinic center in Lake Havasu City, AZ. COLORADO RIVER PAIN MANAGEMENT LLC NPI is 1639405756. The provider is registered as an organization entity type.

The provider's business location address is:

1951 MESQUITE AVE
SUITE I
LAKE HAVASU CITY, AZ
ZIP 86403-746
Phone: (928) 453-3267
Fax: (928) 453-3276

The provider's authorized official is Judith A Spillane .
The authorized official title is Administrator and has the following contact phone number (928) 453-3267.

The CLIA number assigned to this NPI record is 03D2143676 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/23/2009 and was last updated on 11/5/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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