Organization
CERTIFIED SURGICAL FIRST ASSISTANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN E BAGWELL (GENERAL MANAGER)
(480) 545-2610
Entity
Organization
Contact information
Practice address
2925 E RIGGS RD, STE 8-166, CHANDLER, AZ 85249-3600
(480) 545-2610
(480) 545-2673
Mailing address
2925 E RIGGS RD, STE 8-166, CHANDLER, AZ 85249-3600
(602) 909-4623
(480) 545-2673
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
03/29/2016
Last updated
01/11/2022
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