Provider Demographics
NPI:1558613026
Name:SALUD SPINE JOINT AND WELLNESS CENTER
Entity Type:Organization
Organization Name:SALUD SPINE JOINT AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:R
Authorized Official - Last Name:RESTITUYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:774-992-7058
Mailing Address - Street 1:651 ORCHARD STREET, SUITE 202A
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02744
Mailing Address - Country:US
Mailing Address - Phone:774-992-7058
Mailing Address - Fax:774-992-7061
Practice Address - Street 1:651 ORCHARD STREET, SUITE 202A
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02744
Practice Address - Country:US
Practice Address - Phone:774-992-7058
Practice Address - Fax:774-992-7061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230970261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty