Provider Demographics
NPI:1295158129
Name:INTEGRITY SPORT & SPINE CHIROPRACTIC CENTER, LLC
Entity type:Organization
Organization Name:INTEGRITY SPORT & SPINE CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:E
Authorized Official - Last Name:RINOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-595-2344
Mailing Address - Street 1:100 BIDDLE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3981
Mailing Address - Country:US
Mailing Address - Phone:302-595-2344
Mailing Address - Fax:302-595-2134
Practice Address - Street 1:100 BIDDLE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3981
Practice Address - Country:US
Practice Address - Phone:302-595-2344
Practice Address - Fax:302-595-2134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE019399ZCBFOtherPTAN
DE1851577878OtherNPI