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General NPI Number Information
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NPI Number | 1720338676
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Entity Type | Organization
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Legal Business Name | RANGE SPINE CENTER, PLLC
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 4104 9TH AVE W
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City | HIBBING
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State | MN
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Zip | 55746-3020
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Country | US
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Telephone | 218-969-4928
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Fax |
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Provider Business Mailing Address
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Address Line | 4104 9TH AVE W
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City | HIBBING
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State | MN
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Zip | 55746-3020
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/DOCTOR OF CHIROPRACTIC
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Name | DR. NICHOLAS GEORGE ONGARO
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Credential | D.C.
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Telephone | 218-969-4928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5322
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5467
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License Number State | MN
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