Provider Demographics
NPI:1912202888
Name:PHYSICIANS PLUS SPINE AND REHAB CENTER
Entity Type:Organization
Organization Name:PHYSICIANS PLUS SPINE AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:FEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-744-2684
Mailing Address - Street 1:PO BOX 1304
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-7304
Mailing Address - Country:US
Mailing Address - Phone:302-376-7107
Mailing Address - Fax:
Practice Address - Street 1:835 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1240
Practice Address - Country:US
Practice Address - Phone:302-328-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEGO1891U01Medicare PIN