MEDICARE: ALPHA SPINE CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR006361	GA

General Provider Information

NPI Number	:	1700181237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA SPINE CENTER, INC.

Provider Business Mailing Address
First Line	:	12220 BIRMINGHAM HWY
Second Line	:	SUITE 40
City	:	MILTON
State	:	GA
Zip	:	30004-4186
Country	:	US
Telephone Number	:	770-777-2377
Fax Number	:

Provider Business Practice Location Address
First Line	:	12220 BIRMINGHAM HWY
Second Line	:	SUITE 40
City	:	MILTON
State	:	GA
Zip	:	30004-4186
Country	:	US
Telephone Number	:	770-777-2377
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRYAN J. SALMINEN
Credential	:	D.C
Telephone Number	:	770-777-2377

Provider Enumeration Date	:	01/13/2011
Last Update Date	:	07/09/2015

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