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General NPI Number Information
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NPI Number | 1033871959
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Entity Type | Organization
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Legal Business Name | BRIGHTON SPINE AND WELLNESS PC
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 697 CAMBRIDGE ST # 303
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City | BRIGHTON
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State | MA
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Zip | 02135-2897
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Country | US
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Telephone | 407-230-7082
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Fax |
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Provider Business Mailing Address
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Address Line | 697 CAMBRIDGE ST # 303
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City | BRIGHTON
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State | MA
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Zip | 02135-2897
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Country | US
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Telephone | 407-230-7082
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW HERBA
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Credential | DC
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Telephone | 407-230-7082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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