SearchArizona246ZS0410X

Jason Fort, CST/CSA

NPI 1417228909 · on the registry since 2012 · sole proprietor

Practice

Address
2778 E Superior Rd
San Tan Valley, AZ 85143
Phone
(480) 313-9045
Fax
(480) 987-2186

Registry record

Primary taxonomy
246ZS0410X
246ZS0410X
Also registered as
246ZS0410X
Licence states on file
OR, AZ
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-08-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona