Healthcare Provider Details

I. General information

NPI: 1902125404
Provider Name (Legal Business Name): NEXT LEVEL SPINE AND SPORTS INJURY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 10/10/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 NICHOLSON RD STE 3120
SEWICKLEY PA
15143-7608
US

IV. Provider business mailing address

2605 NICHOLSON RD STE 3120
SEWICKLEY PA
15143-7608
US

V. Phone/Fax

Practice location:
  • Phone: 724-719-2900
  • Fax: 724-719-2901
Mailing address:
  • Phone: 724-719-2900
  • Fax: 724-719-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTIN D SCOTT
Title or Position: PRESIDENT
Credential: D.C.
Phone: 814-397-7704