Basic Information
| Provider Information | |||||||||
| NPI: | 1639317399 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE NEUROSPINE CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 730 EDEN RD. | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175814813 | ||||||||
| FaxNumber: | 7175694210 | ||||||||
| Practice Location | |||||||||
| Address1: | 730 EDEN RD. | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175814813 | ||||||||
| FaxNumber: | 7175694210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2009 | ||||||||
| LastUpdateDate: | 03/18/2019 | ||||||||
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| AuthorizedOfficialLastName: | LOWTHER | ||||||||
| AuthorizedOfficialFirstName: | MARTIN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 7175814813 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.