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General NPI Number Information
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NPI Number | 1073315412
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Entity Type | Organization
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Legal Business Name | SUMMIT INTEGRATED INJURY
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 2670 CRIMSON CANYON DR STE 150
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City | LAS VEGAS
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State | NV
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Zip | 89128-0848
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Country | US
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Telephone | 702-359-7246
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6610
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City | CHANDLER
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State | AZ
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Zip | 85246-6610
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Country | US
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Telephone | 480-926-7800
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Fax | 480-926-2260
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | SENA FORD
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Credential |
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Telephone | 480-926-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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