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General NPI Number Information
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NPI Number | 1053336917
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Entity Type | Organization
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Legal Business Name | SPINAL INTERVENTIONS, PLLC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 280 WEST RIVER PARK DR STE 200
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City | PROVO
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State | UT
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Zip | 84604-5764
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Country | US
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Telephone | 801-223-4860
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Fax | 801-371-8993
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Provider Business Mailing Address
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Address Line | 280 RIVER PARK DR STE 200
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City | PROVO
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State | UT
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Zip | 84604-5793
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Country | US
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Telephone | 801-223-4860
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Fax | 801-371-8993
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Authorized Official
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Title or Position | MANAGER
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Name | DANIEL REY FABER
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Credential | MD
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Telephone | 801-380-6239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 45356
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License Number State | UT
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