Provider Demographics
NPI:1437185048
Name:ELITE SCHOOL OF SURGICAL FIRST ASSISTS LLC
Entity Type:Organization
Organization Name:ELITE SCHOOL OF SURGICAL FIRST ASSISTS LLC
Other - Org Name:ESSFA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-609-2600
Mailing Address - Street 1:3223 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-8175
Mailing Address - Country:US
Mailing Address - Phone:316-609-2600
Mailing Address - Fax:306-609-2827
Practice Address - Street 1:3223 N WEBB RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-8175
Practice Address - Country:US
Practice Address - Phone:316-609-2600
Practice Address - Fax:306-609-2827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty