Provider Demographics
NPI:1932409604
Name:SIERRA PACIFIC ORTHOPAEDICS THERAPY
Entity Type:Organization
Organization Name:SIERRA PACIFIC ORTHOPAEDICS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LYNDSI
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-256-5200
Mailing Address - Street 1:1630 E HERNDON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3305
Mailing Address - Country:US
Mailing Address - Phone:559-256-5200
Mailing Address - Fax:559-256-5376
Practice Address - Street 1:1630 E HERNDON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3305
Practice Address - Country:US
Practice Address - Phone:559-256-5200
Practice Address - Fax:559-256-5376
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIERRA PACIFIC ORTHOPAEDIC CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy