Surette, Roger
Surette, Roger is an sole proprietor health care provider with primary practice located at 302 El Camino Real #106, Sierra Vista AZ 85635. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Surette, Roger can be contacted via phone (520) 458-5105.Contact Information
Primary practice address
302 El Camino Real #106
Sierra Vista AZ 85635
Phone: (520) 458-5105
Fax: (520) 459-2357
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1091 | Arizona |
Profile Details
| NPI number | 1205875895 |
|---|---|
| LBN Legal business name | Surette, Roger |
| Credentials | MSPT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Jan 3rd, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205875895 | NPPES |
| Arizona | MEDICAID | 782062 | |
| Arizona | Other | P00248760 | |
| Arizona | Other | 2X1712 |
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