Provider Demographics
NPI:1609297969
Name:SPINE RE-NEW LLC
Entity Type:Organization
Organization Name:SPINE RE-NEW LLC
Other - Org Name:BERLENER CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERLENER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-351-3590
Mailing Address - Street 1:7200 E DRY CREEK RD
Mailing Address - Street 2:A101
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2537
Mailing Address - Country:US
Mailing Address - Phone:303-351-3590
Mailing Address - Fax:303-552-2078
Practice Address - Street 1:7200 E DRY CREEK RD
Practice Address - Street 2:A101
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2537
Practice Address - Country:US
Practice Address - Phone:303-351-3590
Practice Address - Fax:303-552-2078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty