Provider Demographics
NPI:1336281658
Name:SPINAL HEALTH & REHAB CENTER LLC
Entity Type:Organization
Organization Name:SPINAL HEALTH & REHAB CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASALINO
Authorized Official - Suffix:IV
Authorized Official - Credentials:DC
Authorized Official - Phone:401-247-2991
Mailing Address - Street 1:20 BOSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4105
Mailing Address - Country:US
Mailing Address - Phone:401-247-2991
Mailing Address - Fax:401-245-7510
Practice Address - Street 1:20 BOSWORTH ST
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-4105
Practice Address - Country:US
Practice Address - Phone:401-247-2991
Practice Address - Fax:401-245-7510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI6651050001Medicare NSC
RI709003509Medicare ID - Type UnspecifiedGROUP NUMBER