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NPI Code Detail

MEDICARE: TOTAL SPINE CARE & INJURY REHABILITATION CENTER, LLC

MEDICARE: TOTAL SPINE CARE & INJURY REHABILITATION CENTER, LLC
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
1111NR0400XRehabilitation Chiropractor7886DCTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17886DCOTHERTXTBCE LIC. NO.

General Provider Information

NPI Number : 1528189982
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTAL SPINE CARE & INJURY REHABILITATION CENTER, LLC
Provider Business Mailing Address
First Line : PO BOX 310701
Second Line :
City : NEW BRAUNFELS
State : TX
Zip : 78131-0701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5403 JACKWOOD DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78238-1809
Country : US
Telephone Number : 210-682-3333
Fax Number :
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. KEVIN DYKES SHRUM
Credential :
Telephone Number : 210-748-7200
Provider Enumeration Date : 04/03/2007
Last Update Date : 08/22/2020

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Directions to “TOTAL SPINE CARE & INJURY REHABILITATION CENTER, LLC ” Practice Location

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