Provider Demographics
NPI:1780217836
Name:SPINE & NECK INJURY CENTER
Entity Type:Organization
Organization Name:SPINE & NECK INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZILU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-849-5077
Mailing Address - Street 1:30B NORTHWEST AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-1830
Mailing Address - Country:US
Mailing Address - Phone:330-849-5077
Mailing Address - Fax:234-678-4848
Practice Address - Street 1:30B NORTHWEST AVE STE 110
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-1830
Practice Address - Country:US
Practice Address - Phone:330-849-5077
Practice Address - Fax:234-678-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty