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General NPI Number Information
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NPI Number | 1063610087
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Entity Type | Organization
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Legal Business Name | SPINAL THERAPEUTIC SERVICES INC
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 4415 S HARVARD AVE STE. 204
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City | TULSA
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State | OK
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Zip | 74135-2620
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Country | US
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Telephone | 918-743-1133
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Fax | 918-743-6993
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Provider Business Mailing Address
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Address Line | 4415 S HARVARD AVE STE. 204
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City | TULSA
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State | OK
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Zip | 74135-2620
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Country | US
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Telephone | 918-743-1133
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Fax | 918-743-6993
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CRAIG HUEY
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Credential |
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Telephone | 918-743-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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