Provider Demographics
NPI:1659917649
Name:TOLEDO SPINE JOINT AND PAIN LLC
Entity Type:Organization
Organization Name:TOLEDO SPINE JOINT AND PAIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIF
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-528-7398
Mailing Address - Street 1:6855 SPRING VALLEY DR STE 150
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-7012
Mailing Address - Country:US
Mailing Address - Phone:203-528-7398
Mailing Address - Fax:
Practice Address - Street 1:6855 SPRING VALLEY DR STE 150
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-7012
Practice Address - Country:US
Practice Address - Phone:203-528-7398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty