Provider Demographics
NPI:1922032705
Name:HERRING SPINE & REHAB, INC.
Entity Type:Organization
Organization Name:HERRING SPINE & REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:334-745-5321
Mailing Address - Street 1:2011 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6836
Mailing Address - Country:US
Mailing Address - Phone:334-745-5321
Mailing Address - Fax:334-745-5358
Practice Address - Street 1:2011 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6836
Practice Address - Country:US
Practice Address - Phone:334-745-5321
Practice Address - Fax:334-745-5358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0980111N00000X
AL1176111N00000X
AL00023346207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty