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 (VP FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
5890 W 13TH ST, STE 101, GREELEY, CO 80634-4821
(970) 348-0020
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
(602) 747-4000
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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