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General NPI Number Information
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NPI Number | 1124438403
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Entity Type | Organization
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Legal Business Name | SPINAL CONNECTION INC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 1940 5TH AVE STE 302
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City | SAN DIEGO
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State | CA
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Zip | 92101-2364
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Country | US
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Telephone | 619-540-9270
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 5TH AVE STE 302
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City | SAN DIEGO
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State | CA
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Zip | 92101-2364
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Country | US
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Telephone | 619-540-9270
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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. KATHRYN J FOX
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Credential | DC
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Telephone | 619-540-9270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 31551
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License Number State | CA
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