Individual
DR. SEAN SOUTHLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, MDAST, CBIS
Contact information
Practice address
1155 W RIO SALADO PKWY STE 101, TEMPE, AZ 85281-2826
(480) 696-5796
Mailing address
17470 N PACESETTER WAY, SCOTTSDALE, AZ 85255-5445
(480) 278-6609
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
Primary
18909
AZ
Other
Enumeration date
08/03/2017
Last updated
06/11/2019
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