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Contact Information

ACTIVE LIFE PHYSICAL MEDICINE AND PAIN CENTER, PLLC
15547 N REEMS RD BLDG A
SURPRISE, AZ85374-9583
 Phone: 623-535-9777
 Fax: 623-535-9778
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for ACTIVE LIFE PHYSICAL MEDICINE AND PAIN CENTER, PLLC

NPI # 1811130016
LBN Legal business name ACTIVE LIFE PHYSICAL MEDICINE AND PAIN CENTER, PLLC
Authorized official WENDI LUNDQUIST - (OWNER/PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 04/17/2009
Last updated 05/29/2023 - About 3 years ago
Identifiers
AZ License # 005097
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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