Organization
SUN VALLEY SPINE AND ORTHOPEDICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH JACKNOWITZ (CRO)
(469) 459-9754
Entity
Organization
Contact information
Practice address
1440 E MISSOURI AVE STE C102, PHOENIX, AZ 85014-2459
(480) 877-1497
(480) 582-0366
Mailing address
4400 STATE HIGHWAY 121 STE 405, LEWISVILLE, TX 75056-4561
(469) 459-9754
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
10/01/2021
Last updated
10/18/2023
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