Organization
PLASTIC AND PERIPHERAL NERVE SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN WOLFORT MD (MEMBER)
(480) 802-8511
Entity
Organization
Contact information
Practice address
25229 S SUN LAKES BLVD STE 101, SUN LAKES, AZ 85248-6465
(480) 802-8511
(480) 802-8129
Mailing address
25229 S SUN LAKES BLVD STE 101, SUN LAKES, AZ 85248-6465
(480) 802-8511
(480) 802-8129
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
07/03/2019
Last updated
07/18/2019
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