Provider Demographics
NPI:1457587545
Name:FIRST ASSISTANTS RELIABLY THERE LLC
Entity Type:Organization
Organization Name:FIRST ASSISTANTS RELIABLY THERE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROP.
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:CFA
Authorized Official - Phone:928-310-8146
Mailing Address - Street 1:1401 N NAVAJO DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-1205
Mailing Address - Country:US
Mailing Address - Phone:928-310-8146
Mailing Address - Fax:
Practice Address - Street 1:1200 N BEAVER ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3118
Practice Address - Country:US
Practice Address - Phone:928-779-3366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Multi-Specialty