Provider Demographics
NPI:1346955960
Name:THE SPINE DOCS, LLC
Entity Type:Organization
Organization Name:THE SPINE DOCS, LLC
Other - Org Name:NORTH MESA CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVRIELLE
Authorized Official - Middle Name:CAROLINE
Authorized Official - Last Name:SIMONEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-577-6174
Mailing Address - Street 1:1925 E BROWN RD STE A1
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-5135
Mailing Address - Country:US
Mailing Address - Phone:480-969-2425
Mailing Address - Fax:
Practice Address - Street 1:1925 E BROWN RD STE A1
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-5135
Practice Address - Country:US
Practice Address - Phone:480-969-2425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty