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General NPI Number Information
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NPI Number | 1831858455
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Entity Type | Organization
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Legal Business Name | SPINE AND NEURO HEALTH AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 850 GENEVA PKWY N STE 100
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City | LAKE GENEVA
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State | WI
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Zip | 53147-4562
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Country | US
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Telephone | 262-956-9067
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Fax |
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Provider Business Mailing Address
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Address Line | 850 LAKE GENEVA PARKWAY N SUITE 100
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City | LAKE GENEVA
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State | WI
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Zip | 53147-4562
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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 | MEDICAL DIRECTOR
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Name | ARVIND AHUJA
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Credential | MD
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Telephone | 262-956-9067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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