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General NPI Number Information
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NPI Number | 1801348826
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Entity Type | Organization
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Legal Business Name | FLOW SPINE & SPORT LLC
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 123 DONOHOE DRIVE
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City | GREENSBURG
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State | PA
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Zip | 15601
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Country | US
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Telephone | 724-984-8102
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Fax |
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Provider Business Mailing Address
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Address Line | 123 DONOHOE DRIVE
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City | GREENSBURG
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State | PA
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Zip | 15601
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Country | US
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Telephone | 724-984-8102
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS NERATKA
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Credential | D.C.
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Telephone | 724-984-8102
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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 | DC010918
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License Number State | PA
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