| LCA CASE NUMBER | I-200-19297-107189 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2019-10-24 |
| DECISION DATE | 2019-10-31 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Emergency Medicine Physician & Assistant Program D |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | N |
| LCA CASE EMPLOYMENT START DATE | 2020-01-01 |
| END DATE | 2022-12-31 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | St. John Emergency Services, P.C. |
| EMPLOYER ADDRESS1 | 265 Brookview Center Way |
| EMPLOYER ADDRESS2 | Ste. 400 |
| EMPLOYER CITY | Knoxville |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37919 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | +18005777707 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Goins |
| EMPLOYER POC FIRST NAME | Tiffany |
| EMPLOYER POC JOB TITLE | Immigration Specialist |
| EMPLOYER POC ADDRESS1 | 265 Brookview Center Way |
| EMPLOYER POC ADDRESS2 | Ste. 400 |
| EMPLOYER POC CITY | Knoxville |
| EMPLOYER POC STATE | TN |
| EMPLOYER POC POSTAL CODE | 37919 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | +18657696680 |
| EMPLOYER POC EMAIL | tiffany_goins@teamhealth.com |
| 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 | rbus@breljelaw.com |
| 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 | Y |
| SECONDARY ENTITY BUSINESS NAME | Ascension St. John Hospital |
| WORKSITE ADDRESS1 | 22101 Moross Road |
| LCA CASE WORKLOC1 CITY | Detroit |
| WORKSITE COUNTY | WAYNE |
| LCA CASE WORKLOC1 STATE | MI |
| WORKSITE POSTAL CODE | 48236 |
| LCA CASE WAGE RATE FROM | 155.0 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 49.0 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| 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, P.C. |
| PREPARER EMAIL | ksmith@breljelaw.com |
