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General NPI Number Information
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NPI Number | 1982644761
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Entity Type | Organization
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Legal Business Name | NORTHWEST NEUROSPINE INSTITUTE, LLC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 74B CENTENNIAL LOOP SUITE 200
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City | EUGENE
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State | OR
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Zip | 97401-2451
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Country | US
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Telephone | 541-393-0925
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Fax | 541-393-0914
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Provider Business Mailing Address
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Address Line | 74B CENTENNIAL LOOP SUITE 200
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City | EUGENE
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State | OR
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Zip | 97401-2451
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Country | US
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Telephone | 541-393-0925
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Fax | 541-393-0914
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JAMES H COBB
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Credential |
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Telephone | 541-431-0665
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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 | 071578
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License Number State | OR
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