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General NPI Number Information
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NPI Number | 1396967857
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Entity Type | Organization
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Legal Business Name | NEUROSPINE CENTER
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 335 BILLINGSLEY RD SUITE 101
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City | CHARLOTTE
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State | NC
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Zip | 28211-1040
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Country | US
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Telephone | 704-333-1913
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Fax | 704-333-1933
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Provider Business Mailing Address
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Address Line | 335 BILLINGSLEY RD SUITE 101
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City | CHARLOTTE
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State | NC
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Zip | 28211-1040
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Country | US
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Telephone | 704-333-1913
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Fax | 704-333-1933
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Authorized Official
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Title or Position | PRACTICE COORDINATOR
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Name | ALLY R. CAGLE
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Credential | RTR-CV
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Telephone | 704-333-1913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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