Provider Demographics
NPI:1558782979
Name:JOSHUA SPINE AND HEALTH CENTER, PC
Entity Type:Organization
Organization Name:JOSHUA SPINE AND HEALTH CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-571-4996
Mailing Address - Street 1:332 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:JOSHUA
Mailing Address - State:TX
Mailing Address - Zip Code:76058-3047
Mailing Address - Country:US
Mailing Address - Phone:817-641-1313
Mailing Address - Fax:817-641-1314
Practice Address - Street 1:332 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:JOSHUA
Practice Address - State:TX
Practice Address - Zip Code:76058-3047
Practice Address - Country:US
Practice Address - Phone:817-641-1313
Practice Address - Fax:817-641-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty