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General NPI Number Information
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NPI Number | 1639440498
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Entity Type | Organization
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Legal Business Name | ONE SPINE CORPORATION
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Dates
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Enumeration Date | 01/25/2012
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Last Update Date | 01/25/2012
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Provider Practice Location Address
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Address Line | TORRE SAN VICENTE DE PAUL SUITE 309
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-892-6972
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Fax | 787-892-6972
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Provider Business Mailing Address
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Address Line | PO BOX 1103
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City | YAUCO
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State | PR
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Zip | 00698-1103
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Country | US
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Telephone | 787-892-6972
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Fax | 787-892-6972
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Authorized Official
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Title or Position | MD
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Name | DR. WALLY LOPEZ
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Credential |
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Telephone | 787-371-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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