Healthcare Provider Details

I. General information

NPI: 1093855876
Provider Name (Legal Business Name): SPINAL MONITORING SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10103 RIDGEGATE PKWY SUITE 306
LONE TREE CO
80124-5520
US

IV. Provider business mailing address

451 WISSAHICKON AVE
CEDARTOWN GA
30125-2553
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-8120
  • Fax: 303-225-8130
Mailing address:
  • Phone: 678-988-0571
  • Fax: 770-748-6211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberNOT REQUIRED
License Number StateCO

VIII. Authorized Official

Name: JUDITH HALL SUMMERFORD
Title or Position: OFFICE MANAGER
Credential:
Phone: 678-988-0571