Provider Demographics
NPI:1831117662
Name:SPREADING OAK SPINAL CARE & REHABILITATION, PLC
Entity Type:Organization
Organization Name:SPREADING OAK SPINAL CARE & REHABILITATION, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:EVANS
Authorized Official - Last Name:JOINER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:540-772-4448
Mailing Address - Street 1:PO BOX 20764
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0077
Mailing Address - Country:US
Mailing Address - Phone:540-772-4448
Mailing Address - Fax:540-772-0410
Practice Address - Street 1:4519 BRAMBLETON AVE
Practice Address - Street 2:SUITE # 302
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3436
Practice Address - Country:US
Practice Address - Phone:540-772-4448
Practice Address - Fax:540-772-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherCHAMPUS/TRICARE