MEDICARE: SALLY ROBISON CASS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251H1200X	Hand Physical Therapist	1587	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427046762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALLY ROBISON CASS

Provider Business Mailing Address
First Line	:	401 N SAN FRANCISCO ST STE B
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-4698
Country	:	US
Telephone Number	:	928-779-6391
Fax Number	:	928-779-6391

Provider Business Practice Location Address
First Line	:	401 N SAN FRANCISCO ST
Second Line	:	STE B
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-4649
Country	:	US
Telephone Number	:	928-773-4840
Fax Number	:	928-773-4843

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	11/18/2008

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Directions to “ SALLY ROBISON CASS ” Practice Location

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