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General NPI Number Information
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NPI Number | 1609250232
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC & SPINE CENTER LLC
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 1080 POLARIS PKWY SUITE 200
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City | COLUMBUS
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State | OH
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Zip | 43240-6035
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Country | US
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Telephone | 614-468-0284
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Fax | 614-468-0210
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Provider Business Mailing Address
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Address Line | 1080 POLARIS PKWY SUITE 200
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City | COLUMBUS
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State | OH
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Zip | 43240-6035
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Country | US
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Telephone | 614-468-0284
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Fax | 614-468-0210
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Authorized Official
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Title or Position | MEDICAL DOCTOR / MEDICAL DIRECTOR
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Name | KEDAR KRISHNA DESHPANDE
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Credential | M.D.
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Telephone | 614-468-0284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 021271
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License Number State | OH
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