Organization
ROGER SURETTE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY KAPLAN (CONTRACTS)
(520) 458-6331
Entity
Organization
Contact information
Practice address
302 EL CAMINO REAL STE 10G, SIERRA VISTA, AZ 85635-2825
(520) 458-5105
(520) 459-2357
Mailing address
302 EL CAMINO REAL STE 10G, SIERRA VISTA, AZ 85635-2825
(520) 458-5105
(520) 459-2357
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1091
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z1712
HN
AZ
05
—
782062
—
AZ
01
—
P00248760
RRMEDICARE
AZ
Enumeration date
07/23/2006
Last updated
05/14/2008
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