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General NPI Number Information
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NPI Number | 1538983721
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Entity Type | Organization
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Legal Business Name | SIERRA NEVADA MOBILE PHLEBOTOMY
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 686 W LINE ST
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City | BISHOP
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State | CA
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Zip | 93514-3315
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Country | US
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Telephone | 760-582-6789
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Fax | 760-678-6088
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Provider Business Mailing Address
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Address Line | 686 W LINE ST
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City | BISHOP
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State | CA
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Zip | 93514-3315
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Country | US
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Telephone | 760-582-6789
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Fax | 760-678-6088
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL GRACE
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Credential |
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Telephone | 720-975-6915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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