Provider Demographics
NPI:1063627909
Name:MOBILE SPINE AND REHABILITATION LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:MOBILE SPINE AND REHABILITATION LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:6051 AIRPORT BLVD
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3167
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6051 AIRPORT BLVD
Practice Address - Street 2:SUITE A 1
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3167
Practice Address - Country:US
Practice Address - Phone:251-460-0201
Practice Address - Fax:251-460-2848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1272770001Medicare NSC