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General NPI Number Information
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NPI Number | 1801940218
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Entity Type | Organization
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Legal Business Name | SUTTERHEALTH
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9280 W STOCKTON BLVD
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City | ELK GROVE
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State | CA
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Zip | 95758-8073
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Country | US
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Telephone | 916-683-2580
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Fax |
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Provider Business Mailing Address
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Address Line | 5922 PALM SPRINGS CT
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City | ELK GROVE
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State | CA
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Zip | 95758-6149
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Country | US
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Telephone | 916-205-9264
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Fax |
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Authorized Official
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Title or Position | CERTIFIED ATHLETIC TRAINER
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Name | MR. AARON SCOTT FRASER
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Credential | A.T.C
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Telephone | 916-683-2580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | CA
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