Healthcare Provider Details

I. General information

NPI: 1538171004
Provider Name (Legal Business Name): SPINECARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11743 COUNTY LINE RD STE A
MADISON AL
35758-3301
US

IV. Provider business mailing address

11743 COUNTY LINE RD STE A
MADISON AL
35758-3301
US

V. Phone/Fax

Practice location:
  • Phone: 256-461-7775
  • Fax: 256-584-2756
Mailing address:
  • Phone: 256-461-7775
  • Fax: 256-584-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number1995
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1995
License Number StateAL

VIII. Authorized Official

Name: DR. ANTHONY F HOUSSAIN
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 256-461-7775