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General NPI Number Information
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NPI Number | 1881068427
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Entity Type | Organization
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Legal Business Name | ADVANCED SPINE JOINT AND WELLNESS CENTER
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 3591 RESERVE COMMONS DR SUITE 100
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City | MEDINA
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State | OH
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Zip | 44256-5334
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Country | US
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Telephone | 330-721-6504
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Fax | 330-721-6508
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Provider Business Mailing Address
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Address Line | 3591 RESERVE COMMONS DR SUITE 100
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City | MEDINA
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State | OH
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Zip | 44256-5334
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Country | US
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Telephone | 330-721-6504
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Fax | 330-721-6508
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Authorized Official
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Title or Position | OWNER
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Name | TROY NAFTZGER
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Credential | PA
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Telephone | 330-721-6504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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