Provider Demographics
NPI:1184961773
Name:ASHEVILLE SPINE AND NERVE INSTITUTE PC
Entity type:Organization
Organization Name:ASHEVILLE SPINE AND NERVE INSTITUTE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-253-0700
Mailing Address - Street 1:190 BROADWAY ST APT 205
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2514
Mailing Address - Country:US
Mailing Address - Phone:828-253-0700
Mailing Address - Fax:
Practice Address - Street 1:190 BROADWAY ST APT 205
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2514
Practice Address - Country:US
Practice Address - Phone:828-253-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU67484Medicare UPIN