| LCA CASE NUMBER | I-200-19352-205827 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2019-12-18 |
| DECISION DATE | 2019-12-26 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2019-12-30 |
| END DATE | 2022-12-29 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| LCA CASE EMPLOYER NAME | North Country HealthCare, Inc. |
| EMPLOYER ADDRESS1 | 2920 N 4th Street |
| EMPLOYER CITY | Flagstaff |
| EMPLOYER STATE | AZ |
| EMPLOYER POSTAL CODE | 86004 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | +19285229514 |
| NAICS CODE | 621498 |
| EMPLOYER POC LAST NAME | Seby |
| EMPLOYER POC FIRST NAME | Sandra |
| EMPLOYER POC JOB TITLE | Senior Recruiter |
| EMPLOYER POC ADDRESS1 | 2920 N 4th Street |
| EMPLOYER POC CITY | Flagstaff |
| EMPLOYER POC STATE | AZ |
| EMPLOYER POC POSTAL CODE | 86004 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | +19285229514 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Bus |
| AGENT ATTORNEY FIRST NAME | Rachel |
| AGENT ATTORNEY MIDDLE NAME | I. |
| AGENT ATTORNEY ADDRESS1 | 3080 N. Litchfield Road |
| AGENT ATTORNEY CITY | Goodyear |
| AGENT ATTORNEY STATE | AZ |
| AGENT ATTORNEY POSTAL CODE | 85395 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16235365750.0 |
| AGENT ATTORNEY PHONE EXT | 1020.0 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Brelje and Associates, PC |
| STATE OF HIGHEST COURT | TX |
| NAME OF HIGHEST STATE COURT | Supreme |
| WORKSITE WORKERS | 1.0 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 2650 E Show Low Lake Road |
| WORKSITE ADDRESS2 | Suite 1 |
| LCA CASE WORKLOC1 CITY | Show Low |
| WORKSITE COUNTY | NAVAJO |
| LCA CASE WORKLOC1 STATE | AZ |
| WORKSITE POSTAL CODE | 85901 |
| LCA CASE WAGE RATE FROM | 180000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 171787.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 2.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Smith |
| PREPARER FIRST NAME | Kerri |
| PREPARER MIDDLE INITIAL | J |
| PREPARER BUSINESS NAME | Law Offices of Brelje and Associates, PC |
| PREPARER EMAIL | [email protected] |
