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Organization

BANNER MOUNTAIN VISTA ORTHOPAEDIC MEDICAL CLINIC

Active
Parent organization
BANNER HEALTH
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VP FINANCE)
(602) 747-4000
Entity
Organization

Contact information

Practice address
6801 W 20TH ST, STE 201, GREELEY, CO 80634-9637
(970) 330-1090
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Enumeration date
09/09/2009
Last updated
09/09/2009
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