Provider Demographics
NPI:1992480586
Name:SITTLER INTEGRATIVE PC
Entity type:Organization
Organization Name:SITTLER INTEGRATIVE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:POLATTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-709-3628
Mailing Address - Street 1:7035 W ANN RD STE 160
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3868
Mailing Address - Country:US
Mailing Address - Phone:702-430-1126
Mailing Address - Fax:
Practice Address - Street 1:7035 W ANN RD STE 160
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3868
Practice Address - Country:US
Practice Address - Phone:702-430-1126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies