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General NPI Number Information
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NPI Number | 1679780381
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Entity Type | Organization
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Legal Business Name | SEQUENT CORPORATION
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 10520 S EASTERN AVE #100
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City | HENDERSON
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State | NV
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Zip | 89052-3900
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Country | US
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Telephone | 702-838-8111
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Fax | 702-838-8115
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Provider Business Mailing Address
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Address Line | 10520 S EASTERN AVE #100
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City | HENDERSON
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State | NV
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Zip | 89052-3900
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Country | US
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Telephone | 702-838-8111
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Fax | 702-838-8115
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEWITT J PAUL
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Credential | C.PED
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Telephone | 714-222-7095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | MP00225
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MP00225
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License Number State | NV
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