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General NPI Number Information
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NPI Number | 1356653000
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Entity Type | Organization
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Legal Business Name | FLAGSTAFF CENTER FOR BONE AND JOINT DISORDERS
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Dates
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Enumeration Date | 07/10/2010
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 525 N SWITZER CANYON DR
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4845
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Country | US
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Telephone | 928-214-2836
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Fax | 928-214-2837
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Provider Business Mailing Address
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Address Line | 525 N SWITZER CANYON DR
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4845
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Country | US
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Telephone | 928-773-2280
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Fax | 928-773-2281
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | KERRI HARLAN
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Credential |
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Telephone | 928-773-2538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 5539
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License Number State | AZ
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