Healthcare Provider Details

I. General information

NPI: 1710226550
Provider Name (Legal Business Name): SOMMER LEIGH PLOTNICK LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SOMMER BLENDEN LMP

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MESA VISTA DR
SEDONA AZ
86351-7639
US

IV. Provider business mailing address

15 MESA VISTA DR
SEDONA AZ
86351-7639
US

V. Phone/Fax

Practice location:
  • Phone: 702-533-2686
  • Fax:
Mailing address:
  • Phone: 702-533-2686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29779
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: