Healthcare Provider Details

I. General information

NPI: 1972296440
Provider Name (Legal Business Name): STRENGE SPINE CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 KENTUCKY AVE STE 102
PADUCAH KY
42003-3815
US

IV. Provider business mailing address

2603 KENTUCKY AVE STE 102
PADUCAH KY
42003-3815
US

V. Phone/Fax

Practice location:
  • Phone: 270-228-3973
  • Fax: 270-359-5046
Mailing address:
  • Phone: 270-228-3973
  • Fax: 270-359-5046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BECKY VINSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 270-519-8200