MEDICARE: SPINECARE INC

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	208VP0000X	Pain Medicine Physician	1995	AL
2	111N00000X	Chiropractor	1995	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51505583	OTHER	AL	BLUE CROSS PROVIDER NUMBER

General Provider Information

NPI Number	:	1538171004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINECARE INC

Provider Business Mailing Address
First Line	:	11743 COUNTY LINE RD STE A
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-3301
Country	:	US
Telephone Number	:	256-461-7775
Fax Number	:	256-584-2756

Provider Business Practice Location Address
First Line	:	11743 COUNTY LINE RD STE A
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-3301
Country	:	US
Telephone Number	:	256-461-7775
Fax Number	:	256-584-2756

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. ANTHONY F HOUSSAIN
Credential	:	DC
Telephone Number	:	256-461-7775

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	11/20/2024

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Directions to “SPINECARE INC ” Practice Location

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