Healthcare Provider Details

I. General information

NPI: 1275576035
Provider Name (Legal Business Name): MOUNTAIN SPINE AND REHABILITATION SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 VANDERBILT PARK DR
ASHEVILLE NC
28803-1700
US

IV. Provider business mailing address

7 VANDERBILT PARK DR
ASHEVILLE NC
28803-1700
US

V. Phone/Fax

Practice location:
  • Phone: 828-255-7776
  • Fax: 828-274-7855
Mailing address:
  • Phone: 828-255-7776
  • Fax: 828-274-7855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number134844
License Number StateNC

VIII. Authorized Official

Name: MR. KEVIN F FLEMING
Title or Position: CEO
Credential: CEO
Phone: 828-255-7776