Advanced Spine and Pain LLC

NPI #1487394888 in Gilbert, Arizona

Provider Information

NPI Number: 1487394888
Entity Type: Organization
Organization Name: Advanced Spine and Pain LLC
Primary Specialty: Internal Medicine
Enumeration Date: Apr 1, 2022
Last Updated: Apr 1, 2022

Practice Location

Address: 2563 S VAL VISTA DR STE 101B
City: Gilbert
State: Arizona
ZIP Code: 85295-6231
Phone: (480) 573-0130

Authorized Official

Name: JARRETT MICHAEL LEATHEM
Title: DO OWNER
Phone: (860) 670-2412

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X
Anesthesiology	207L00000X
Anesthesiology - Pain Medicine — Pain Medicine	207LP2900X
Orthopaedic Surgery	207X00000X
Internal Medicine - Interventional Cardiology — Interventional Cardiology	207RI0011X
Pain Medicine - Interventional Pain Medicine — Interventional Pain Medicine	208VP0014X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Internal Medicine	207R00000X	Primary

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