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General NPI Number Information
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NPI Number | 1356462915
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Entity Type | Organization
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Legal Business Name | JOINT & SPINE CENTER PA
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 100 MEDICAL CENTER PARKWAY SUITE #100
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City | HUNTSVILLE
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State | TX
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Zip | 77340
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Country | US
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Telephone | 936-295-1777
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Fax | 936-295-3680
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Provider Business Mailing Address
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Address Line | 100 MEDICAL CENTER PARKWAY SUITE #100
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City | HUNTSVILLE
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State | TX
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Zip | 77340
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Country | US
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Telephone | 936-295-1777
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Fax | 936-295-3680
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY LEON PRUSKI
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Credential | DC
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Telephone | 936-295-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 5291
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 1036200
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5291
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License Number State | TX
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