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General NPI Number Information
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NPI Number | 1205233269
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Entity Type | Organization
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Legal Business Name | AMARILLO BONE & JOINT CLINIC, LLP
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 1100 S COULTER ST
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City | AMARILLO
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State | TX
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Zip | 79106-1836
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Country | US
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Telephone | 806-468-9700
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Fax | 806-468-9771
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Provider Business Mailing Address
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Address Line | 1100 S COULTER ST
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City | AMARILLO
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State | TX
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Zip | 79106-1836
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Country | US
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Telephone | 806-468-9700
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Fax | 806-468-9771
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Authorized Official
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Title or Position | CERTIFIED SURGICAL TECHNOLOGIST
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Name | ASHLEY NICOLE WHITLEY
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Credential | CST
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Telephone | 806-468-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 137052
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License Number State | TX
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