Provider Demographics
NPI:1588009112
Name:INTEGRATED SPINE & JOINT AT WESTHAVEN PLLC
Entity type:Organization
Organization Name:INTEGRATED SPINE & JOINT AT WESTHAVEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINDSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-798-1937
Mailing Address - Street 1:1025 WESTHAVEN BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-4894
Mailing Address - Country:US
Mailing Address - Phone:615-465-6768
Mailing Address - Fax:
Practice Address - Street 1:1025 WESTHAVEN BLVD
Practice Address - Street 2:STE 210
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-4894
Practice Address - Country:US
Practice Address - Phone:615-465-6768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002161111N00000X
TN43546207X00000X
TN16216363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty