Provider Demographics
NPI:1467795393
Name:R F SPINE CENTER PA
Entity Type:Organization
Organization Name:R F SPINE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:F
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-886-2311
Mailing Address - Street 1:6410 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-1614
Mailing Address - Country:US
Mailing Address - Phone:612-886-2311
Mailing Address - Fax:612-886-2293
Practice Address - Street 1:6410 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-1614
Practice Address - Country:US
Practice Address - Phone:612-886-2311
Practice Address - Fax:612-886-2293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5444111N00000X, 111NR0400X
MN908171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty