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General NPI Number Information
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NPI Number | 1902368483
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Entity Type | Organization
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Legal Business Name | SUBACH SPINAL SOLUTIONS
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 04/03/2019
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Provider Practice Location Address
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Address Line | 1635 N GEORGE MASON DR STE 150
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City | ARLINGTON
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State | VA
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Zip | 22205-3679
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Country | US
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Telephone | 877-782-2241
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Fax |
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Provider Business Mailing Address
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Address Line | 1635 N GEORGE MASON DR STE 150
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City | ARLINGTON
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State | VA
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Zip | 22205-3679
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Country | US
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Telephone | 877-782-2241
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JEFF HOLLIS
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Credential | CPA
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Telephone | 703-981-8205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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