# SAINT AGNES SPINE & SPECIALTY SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Saint Agnes Spine & Specialty Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467940916
- **Authorized official:** JENETHA D MORAN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (972) 763-3893

## Contact information

- **Practice address:** 2365 E FIR AVE, FRESNO, CA 93720-8016
- **Practice address phone:** (559) 797-9100
- **Mailing address:** 2365 E FIR AVE, FRESNO, CA 93720-8016
- **Mailing address phone:** (559) 797-9100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/30/2018
- **Last updated:** 04/30/2018