Provider Demographics
NPI:1417615105
Name:ALLY SPINE CENTER INC.
Entity Type:Organization
Organization Name:ALLY SPINE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:CONDON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-809-4700
Mailing Address - Street 1:10565 N 114TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4942
Mailing Address - Country:US
Mailing Address - Phone:480-809-4700
Mailing Address - Fax:480-809-4704
Practice Address - Street 1:10565 N 114TH ST STE 109
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4942
Practice Address - Country:US
Practice Address - Phone:480-809-4700
Practice Address - Fax:480-809-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty