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General NPI Number Information
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NPI Number | 1457587545
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Entity Type | Organization
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Legal Business Name | FIRST ASSISTANTS RELIABLY THERE LLC
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 1200 N BEAVER ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3118
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Country | US
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Telephone | 928-779-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 N NAVAJO DR
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1205
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Country | US
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Telephone | 928-310-8146
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Fax |
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Authorized Official
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Title or Position | SOLE PROP.
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Name | JOHN R. SPENCER
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Credential | CFA
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Telephone | 928-310-8146
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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 |
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License Number State |
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