Healthcare Provider Details

I. General information

NPI: 1124503917
Provider Name (Legal Business Name): SEW HAPPY SURGICAL ASSISTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 10/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

791 S JELLISON CT
LAKEWOOD CO
80226-4034
US

IV. Provider business mailing address

5885 ALLISON ST UNIT 1029
ARVADA CO
80001-2645
US

V. Phone/Fax

Practice location:
  • Phone: 575-313-9456
  • Fax:
Mailing address:
  • Phone: 303-940-1613
  • Fax: 303-432-2595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: BELINDA MARIE MABRY
Title or Position: OWNER
Credential: CSFA
Phone: 575-313-9456