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General NPI Number Information
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NPI Number | 1154314557
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Entity Type | Organization
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Legal Business Name | ADVANCED SURGICAL ORTHOPEDICS, PS
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 105 W 8TH AVE SUITE 454E
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City | SPOKANE
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State | WA
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Zip | 99204-2302
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Country | US
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Telephone | 509-456-8550
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Fax | 509-838-6562
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Provider Business Mailing Address
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Address Line | PO BOX 405
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City | SPOKANE
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State | WA
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Zip | 99210-0405
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Country | US
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Telephone | 509-456-8550
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Fax | 509-838-6562
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | DR. ALEX VERHOOGEN
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Credential | MD
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Telephone | 509-456-8550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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