Provider Demographics
NPI:1508137324
Name:INFINITY SPINE CENTER PLLC
Entity Type:Organization
Organization Name:INFINITY SPINE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:THOMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-571-5200
Mailing Address - Street 1:3330 S PRICE RD
Mailing Address - Street 2:D110
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7530
Mailing Address - Country:US
Mailing Address - Phone:480-345-2080
Mailing Address - Fax:480-345-2199
Practice Address - Street 1:3330 S PRICE RD
Practice Address - Street 2:D110
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7530
Practice Address - Country:US
Practice Address - Phone:480-345-2080
Practice Address - Fax:480-345-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty