Provider Demographics
NPI:1003112848
Name:SPINE & NECK CENTER, INC.
Entity Type:Organization
Organization Name:SPINE & NECK CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:G
Authorized Official - Last Name:OKELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-468-9466
Mailing Address - Street 1:4100 W 15TH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5803
Mailing Address - Country:US
Mailing Address - Phone:972-468-9466
Mailing Address - Fax:972-964-8678
Practice Address - Street 1:4100 W 15TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5803
Practice Address - Country:US
Practice Address - Phone:972-468-9466
Practice Address - Fax:972-964-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty