MEDICARE: SPINECARE AND REHABILITATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	1454	LA

General Provider Information

NPI Number	:	1033353271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINECARE AND REHABILITATION

Provider Business Mailing Address
First Line	:	2731 MANHATTAN BLVD STE B14
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-6154
Country	:	US
Telephone Number	:	504-362-9500
Fax Number	:	504-362-9295

Provider Business Practice Location Address
First Line	:	2731 MANHATTAN BLVD STE B14
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-6154
Country	:	US
Telephone Number	:	504-362-9500
Fax Number	:	504-362-9295

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	THANH TRAN
Credential	:	DC
Telephone Number	:	504-362-9500

Provider Enumeration Date	:	04/30/2009
Last Update Date	:	04/30/2009

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Directions to “SPINECARE AND REHABILITATION ” Practice Location

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