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General NPI Number Information
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NPI Number | 1801808746
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Entity Type | Organization
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Legal Business Name | SIERRA ORTHOPEDICS, PC
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 1780 E FLORENCE BLVD STE 106
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City | CASA GRANDE
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State | AZ
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Zip | 85122-4782
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Country | US
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Telephone | 520-836-8988
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Fax | 520-836-7930
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Provider Business Mailing Address
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Address Line | 1780 E FLORENCE BLVD STE 106
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City | CASA GRANDE
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State | AZ
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Zip | 85122-4782
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Country | US
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Telephone | 520-836-8988
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Fax | 520-836-7930
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Authorized Official
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Title or Position | MANAGER
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Name | MS. MARTHA A MORENO
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Credential |
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Telephone | 520-836-8988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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