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General NPI Number Information
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NPI Number | 1073301578
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Entity Type | Organization
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Legal Business Name | REGENERATIVE SPINE INJURY CONSULTANTS LLC
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 1623 S PRESTON ST STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40217-1038
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Country | US
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Telephone | 973-979-1370
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Fax |
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Provider Business Mailing Address
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Address Line | 134 SKYLINE VW
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City | FLOYDS KNOBS
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State | IN
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Zip | 47119-8942
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOSEPH LARATTA
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Credential | MD
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Telephone | 973-979-1370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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