Provider Demographics
NPI:1508339029
Name:919 SPINE HS PLLC
Entity Type:Organization
Organization Name:919 SPINE HS PLLC
Other - Org Name:919 SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-342-0900
Mailing Address - Street 1:121 QUANTUM ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8862
Mailing Address - Country:US
Mailing Address - Phone:919-342-0900
Mailing Address - Fax:919-342-0900
Practice Address - Street 1:121 QUANTUM ST
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-8862
Practice Address - Country:US
Practice Address - Phone:919-342-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:919 SPINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-08
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty